Serotonergic function and suicidal behavior in schizophrenia.
Recent studies suggest that altered serotonergic (5-HT) function, as assessed by lower prolactin (PRL) response to fenfluramine (FEN), a specific 5-HT releaser and uptake inhibitor, is associated with suicidal behavior in either depressed and personality disordered patients. The purpose of this study was to investigate, in schizophrenic patients, the relationship between suicidal behavior and PRL response to D-fenfluramine (D-FEN). A D-FEN test was performed in 18 healthy controls and 33 drug-free DSM-IV schizophrenic patients (12 with a history of suicide attempts, 21 without it). Schizophrenic patients with a history of suicide attempts showed a lower PRL response to D-FEN (Delta PRL) compared to schizophrenic patients without such history (P<0.04) and also compared to healthy controls (P<0.0003). Delta PRL did not differentiate schizophrenic patients without suicide attempts and controls. These findings could not be explained by PRL basal hormonal levels, age, sex, menstrual status, demographic or clinical characteristics. These results suggest that PRL response to D-FEN is a marker of suicidal tendencies also in schizophrenia, supporting the hypothesis that a dysfunction in serotonergic function is associated with suicidal behavior regardless of the psychiatric diagnosis.
Corrêa
Humberto
H
Centre Hospitalier, Secteur VIII, 68250 Rouffach, France. rrea@task.com.br
Duval
Fabrice
F
Mokrani
Marie-Claude
MC
Bailey
Paul
P
Trémeau
Fabien
F
Staner
Luc
L
Diep
Than-Son
TS
Crocq
Marc-Antoine
MA
Macher
Jean-Paul
JP
D000328:Adult; D015415:Biomarkers; D005260:Female; D005277:Fenfluramine; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D018570:Risk Assessment; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012701:Serotonin / Q000502:physiology*; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*
D015415:Biomarkers; D005277:Fenfluramine; D012701:Serotonin; D011388:Prolactin