Abnormal neuroendocrine response to clomipramine in hereditary affective psychosis.
BACKGROUND
Blunting of prolactin response after serotonergic stimulation during a major depressive episode has been described by several investigators. In this study, the neuroendocrine responses to clomipramine were assessed in remitted patients suffering from hereditary depression.


METHODS
Twenty remitted patients from 11 large families with multigenerational, multiple cases of major affective disorder (bipolar disorder n=15, recurrent depression n=5, according DSM-IV) and 12 healthy relatives were investigated. After intravenous application of 12.5 mg of the serotonin re-uptake inhibitor clomipramine, serum prolactin and cortisol levels were analysed.


RESULTS
Patients and comparison group did not differ significantly with respect to age, baseline prolactin and cortisol concentrations. A gender effect was found in an exploratory analysis for prolactin but not for cortisol and therefore the data for prolactin were analysed separately. After clomipramine infusion, the increase of cortisol was significantly lower in patients than in the comparison group (P=.046). For prolactin, this effect could be found in the male (P=.012) as well as in the female (P=.007) subsample.


CONCLUSIONS
These results suggest that blunted prolactin and cortisol responses to serotonergic stimulation are characteristic for remitted depressive patients with previous episodes of major affective disorders.
Cordes
Joachim
J
Department of Psychiatry, Heinrich-Heine-University, Düsseldorf, Germany. joachim.cordes@lvr.de
Larisch
Rolf
R
Henning
Uwe
U
Thünker
Johanna
J
Werner
Christian
C
Orozco
Guillermo
G
Mayoral
Fermín
F
Rivas
Fabio
F
Auburger
Georg
G
Tosch
Marco
M
Rietschel
Marcella
M
Gaebel
Wolfgang
W
Müller
Hans-Wilhelm
HW
Klimke
Ansgar
A
D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic; D001714:Bipolar Disorder / Q000097:blood* / Q000235:genetics*; D002997:Clomipramine; D003865:Major Depressive Disorder / Q000097:blood* / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005838:Genotype; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011388:Prolactin / Q000097:blood*; D012016:Reference Values; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics; D017367:Selective Serotonin Reuptake Inhibitors; D013405:Suicide / Q000523:psychology; D055815:Young Adult
D000929:Antidepressive Agents, Tricyclic; D002997:Clomipramine; D006854:Hydrocortisone; D011388:Prolactin; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; C493230:SLC6A4 protein, human