Fenfluramine challenge test in obsessive-compulsive disorder--first results.
Obsessive-compulsive disorder is a chronic psychiatric illness, affecting up to 3% of the general population, to the middle of 60-th it was supposed to be untreatable. Antidepressant pharmacotherapy is one of the treatment alternatives today. We compared efficacy and safety of citalopram versus clomipramine (serotoninergic antidepressants) in 6 weeks in double blind therapy of obsessive-compulsive disorder. The second objective was to compare prolactin response to a fenfluramine challenge test before the treatment of patients and after 6 weeks of the treatment. In a sample of 14 patients we confirmed significant therapeutic response after 3 weeks of pharmacotherapy, better in obsession than in compulsion. We found low level of adverse effects in the first week of therapy--dry mouth, anxiety, nausea, somnolence, tremor, and sexual adverse events. There were no changes in the laboratory, test EEG, and ECG examinations. Fenfluramine challenge test showed statistically significant decrease of prolactin levels 1 hour after administration of fenfluramine. It was not observed after six weeks of the therapy. Statistically significant negative correlation between prolactin plasma levels at the 6th hour after administration of fenfluramine and obsession item of YBOC Scale was showed after the 3rd and 6th week of the therapy. The correlation was not observed for compulsion item YBOC Scale. Side effects observed during and after the challenge test were anxiety and nervousness and gastrointestinal problems, lasted from 1 hour to 10 hours. These preliminary result could support the idea, that obsessions and compulsions have not necessary the same biological background. The challenge paradigm appears to be a possible way to clarify the pathogenesis of OCD. Our study will continue.
Pidrman
V
V
Department of Psychiatry, Charles University, Faculty of Medicine, Hradec Králové.
Tůma
I
I
D000328:Adult; D015283:Citalopram / Q000627:therapeutic use; D002997:Clomipramine / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005277:Fenfluramine; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000097:blood / Q000188:drug therapy*; D011388:Prolactin / Q000097:blood; D018490:Serotonin Agents; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D015283:Citalopram; D002997:Clomipramine; D005277:Fenfluramine; D011388:Prolactin; D018490:Serotonin Agents; D017367:Selective Serotonin Reuptake Inhibitors