title: Prolactin response to dl-fenfluramine challenge before and after treatment with paroxetine.
abstract: The prolactin response to dl-fenfluramine (an indirect central serotonin agonist) challenge has been used to assess serotonergic function and appears to be blunted in depressed patients. We used this method to determine whether the serotonergic deficit in depressed patients is corrected by treatment with paroxetine. Prior to treatment with paroxetine sixteen depressed patients received a placebo challenge followed by a dl-fenfluramine challenge the next day. The same two challenges were repeated after treatment. Prolactin baseline levels were measured before pill administration, and then hourly for 5 hours. Fenfluramine/norfenfluramine levels were assayed at each time point after drug administration. Treatment with paroxetine significantly increased the baseline prolactin level independently of treatment response but positively correlated with paroxetine dose. We found that pre-treatment prolactin response to dl-fenfluramine challenge did not predict clinical response to paroxetine, nor did the prolactin response change significantly after treatment. There was no significant difference in the post-treatment prolactin response between treatment responders and treatment non-responders. We found evidence of increased prolactin levels that may reflect effects of paroxetine in enhancing serotonin levels. Acute release of serotonin as measured by the prolactin response to fenfluramine is not altered by paroxetine treatment.
authors.affiliation: Center for Study of Suicidal Behavior, Department of Neuroscience, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Dulchin
authors.forename: M A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: K M
authors.initials: KM
authors.lastname: Malone
authors.forename: S P
authors.initials: SP
authors.lastname: Ellis
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: J J
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000368:Aged; D015415:Biomarkers; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005277:Fenfluramine; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D011388:Prolactin / Q000097:blood*; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D005277:Fenfluramine; D017374:Paroxetine; D011388:Prolactin; D017367:Selective Serotonin Reuptake Inhibitors