Intravenous clomipramine challenge in obsessive-compulsive disorder: predicting response to oral therapy at eight weeks.
BACKGROUND
Challenge with intravenous clomipramine (CMI) is serotonin selective and has been reported to transiently exacerbate symptoms in obsessive-compulsive disorder (OCD) patients, and to predict subsequent response to oral CMI therapy.


METHODS
We administered CMI (12.5 mg, i.v.) to medication free OCD patients (N = 29) and normal controls (N = 22) to characterize neurohormonal response. A subset of OCD patients (26/29), was then treated with either pulse load i.v. or oral CMI followed by 8 weeks of oral CMI therapy.


RESULTS
In response to CMI challenge, OCD patients exhibit blunted cortisol and exaggerated growth hormone response relative to normal controls. OCD patients differ from controls in "sadness" ratings, with control exhibiting increased dysphoria in response to CMI. Growth hormone response to CMI challenge predicts treatment response (> or = 25% decreases YBOCS from baseline) to oral CMI at 8 weeks.


CONCLUSIONS
Growth hormone abnormalities associated with OCD in response to CMI challenge differentiates nonresponders after 8 weeks of oral CMI treatment from responders.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29403, USA.
F R
FR
Sallee
L M
LM
Koran
S
S
Pallanti
S W
SW
Carson
G
G
Sethuraman
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D002997:Clomipramine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007262:Infusions, Intravenous; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
D002997:Clomipramine; D019382:Human Growth Hormone; D006854:Hydrocortisone; D017367:Selective Serotonin Reuptake Inhibitors