Prolactin response to D-fenfluramine challenge test as a predictor of treatment response to haloperidol in acute schizophrenia.
D-fenfluramine has been identified as a highly selective serotonin (5-HT) releaser and re-uptake inhibitor. The objective of our study was to investigate prolactin response to D-fenfluramine challenge in non-medicated, first episode schizophrenics. We hypothesized that 5-HT reactivity can predict a response to the neuroleptic treatment. Twenty-three inpatients, 11 males and 12 females, at the Prague Psychiatric Center participated in the study. Inclusion criteria were: ICD-10 diagnosis of schizophrenia, first episode or duration of illness shorter than 36 months. D-fenfluramine challenge test was performed before 4 weeks of the haloperidol treatment. During the test, prolactin plasma levels were measured. The Brief Psychiatric Rating Scale (BPRS) was administered before and after the treatment. A statistically significant negative correlation was found between prolactin response to the D-fenfluramine challenge and improvement of psychopathology measured by the change in total BPRS score (p = 0.0004), in positive (p = 0.0403), negative (p = 0.0267), and anxiety-depression symptoms of BPRS (p = 0.0014). Our data support the original hypothesis that there is a relationship between 5-HT system activity and treatment response. The higher responsiveness of the 5-HT system in first episode, non-medicated schizophrenics, was associated with a poorer treatment response to haloperidol, an antidopaminergic neuroleptic.
Mohr
P
P
Prague Psychiatric Center, Praha, 8, Czech Republic. mohr@nki.rfmh.org
Horácek
J
J
Motlová
L
L
Libiger
J
J
Czobor
P
P
D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale; D005260:Female; D005277:Fenfluramine / Q000494:pharmacology*; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D012565:Schizophrenic Psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D012737:Sex Factors
D014150:Antipsychotic Agents; D005277:Fenfluramine; D006220:Haloperidol; D011388:Prolactin; D017367:Selective Serotonin Reuptake Inhibitors