1. Serotonin and the prediction of response time to fluoxetine in patients with mild depression
- Author
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Frances Schopick, Jeremy M. Silverman, Diedre Reynolds, Antonia S. New, Robert L. Trestman, Vivian Mitropoulou, Ann Woo-Ming, and Larry J. Siever
- Subjects
Adult ,Male ,medicine.medical_specialty ,Serotonin ,Fenfluramine ,Serotonin reuptake inhibitor ,Placebo ,Severity of Illness Index ,Serotonin Agents ,Double-Blind Method ,Predictive Value of Tests ,Internal medicine ,Fluoxetine ,medicine ,Humans ,Biological Psychiatry ,Depressive Disorder, Major ,Remission Induction ,medicine.disease ,Prolactin ,Psychiatry and Mental health ,Endocrinology ,Treatment Outcome ,Major depressive disorder ,Antidepressive Agents, Second-Generation ,Female ,Reuptake inhibitor ,Psychology ,Selective Serotonin Reuptake Inhibitors ,medicine.drug - 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.
- Published
- 2000