title: Behavioral responses to catecholamine depletion in unmedicated, remitted subjects with bulimia nervosa and healthy subjects.
abstract: BACKGROUND
  Bulimia nervosa (BN) has been associated with dysregulation of the central catecholaminergic system. An instructive way to investigate the relationship between catecholaminergic function and psychiatric disorder has involved behavioral responses to experimental catecholamine depletion (CD). The purpose of this study was to examine a possible catecholaminergic dysfunction in the pathogenesis of bulimia nervosa.
  
  
  METHODS
  CD was achieved by oral administration of alpha-methyl-para-tyrosine (AMPT) in 18 remitted female subjects with BN (rBN) and 31 healthy female control subjects. The study design consisted of a randomized, double blind, placebo-controlled crossover, single-site experimental trial. The main outcome measures were bulimic symptoms assessed by the Eating Disorder Examination-Questionnaire. Measures were assessed before and 26, 30, 54, 78, 102 hours after the first AMPT or placebo administration.
  
  
  RESULTS
  In the experimental environment (controlled environment with a low level of food cues) rBN subjects had a greater increase in eating disorder symptoms during CD compared with healthy control subjects (condition × diagnosis interaction, p < .05). In the experimental environment, rBN subjects experienced fewer bulimic symptoms than in the natural environment (uncontrolled environment concerning food cues) 36 hours after the first AMPT intake (environment × diagnosis interaction, p < .05). Serum prolactin levels increased significantly, and to a comparable degree across groups, after AMPT administration.
  
  
  CONCLUSIONS
  This study suggests that rBN is associated with vulnerability for developing eating disorder symptoms in response to reduced catecholamine neurotransmission after CD. The findings support the notion of catecholaminergic dysfunction as a possible trait abnormality in BN.
authors.affiliation: Department of Psychiatry and Psychotherapy (SG, LG, HM, GM, US), University Hospital. Electronic address: simona.grob@bluewin.ch.
authors.forename: Simona
authors.initials: S
authors.lastname: Grob
authors.affiliation: Collegium Helveticum (JS), Swiss Federal Institute of Technology Zurich and University of Zurich, Zurich.
authors.forename: Jair
authors.initials: J
authors.lastname: Stern
authors.affiliation: Department of Psychiatry and Psychotherapy (SG, LG, HM, GM, US), University Hospital.
authors.forename: Lara
authors.initials: L
authors.lastname: Gamper
authors.affiliation: Department of Psychiatry and Psychotherapy (SG, LG, HM, GM, US), University Hospital.
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Moergeli
authors.affiliation: Department of Psychiatry and Psychotherapy (SG, LG, HM, GM, US), University Hospital.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Milos
authors.affiliation: Department of Psychiatry and Psychotherapy (SG, LG, HM, GM, US), University Hospital.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.affiliation: Psychiatric University Hospital (GH), University of Bern, Bern, Switzerland.
authors.forename: Gregor
authors.initials: G
authors.lastname: Hasler
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000378:metabolism* / Q000523:psychology*; D002395:Catecholamines / Q000172:deficiency*; D002491:Central Nervous System Agents / Q000494:pharmacology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult; D019805:alpha-Methyltyrosine / Q000494:pharmacology
chemical_list: D002395:Catecholamines; D002491:Central Nervous System Agents; D019805:alpha-Methyltyrosine; D011388:Prolactin
keywords: Behavioral effects; Bulimia nervosa; Catecholamine depletion; Dopamine; Norepinephrine; Pathophysiology