title: Serotonin and the prediction of response time to fluoxetine in patients with mild depression.
abstract: Serotonin (5-HT) dysregulation has been associated with major depressive disorder (MDD); a blunted prolactin (PRL) response to D,L-fenfluramine (FEN) has been associated with MDD. Pharmacologic manipulation of the serotonin system with a selective serotonin reuptake inhibitor (SSRI) is effective in the treatment of depression. However, the relationship between pre-treatment 5-HT activity and response to SSRIs is not well understood. This study investigated the relationship between 5-HT dysregulation and response to fluoxetine (FLU). Twenty patients with MDD entered a double-blind placebo-controlled trial of fluoxetine preceded by D,L-fenfluramine stimulation. Patients were assigned randomly to either FLU, 20 mg QD, or placebo (PLA) for an 11-week trial. No relationship was found between the PRL response to FEN and response to FLU. Among the seven responding to FLU, there was a significant negative correlation between PRL response and the time until sustained response to FLU (r = -0.93, P < 0.001, n = 7). Although preliminary, this study suggests that low baseline serotonin activity may be associated with a slower response to FLU in depression.
authors.affiliation: Department of Psychiatry, Mt. Sinai School of Medicine and Bronx Veterans Affairs Medical Center, NY 10468, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: New
authors.forename: A
authors.initials: A
authors.lastname: Woo-Ming
authors.forename: V
authors.initials: V
authors.lastname: Mitropoulou
authors.forename: J
authors.initials: J
authors.lastname: Silverman
authors.forename: D
authors.initials: D
authors.lastname: Reynolds
authors.forename: F
authors.initials: F
authors.lastname: Schopick
authors.forename: R L
authors.initials: RL
authors.lastname: Trestman
authors.forename: L J
authors.initials: LJ
authors.lastname: Siever
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000494:pharmacology / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D005277:Fenfluramine / Q000627:therapeutic use; D005473:Fluoxetine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011388:Prolactin / Q000097:blood; D012074:Remission Induction; D012701:Serotonin / Q000378:metabolism*; D018490:Serotonin Agents / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005277:Fenfluramine; D005473:Fluoxetine; D011388:Prolactin; D012701:Serotonin; D018490:Serotonin Agents; D017367:Selective Serotonin Reuptake Inhibitors