Plasma prolactin response to d-fenfluramine is blunted in bulimic patients with frequent binge episodes

1998 ◽  
Vol 28 (4) ◽  
pp. 975-983 ◽  
Author(s):  
P. MONTELEONE ◽  
F. BRAMBILLA ◽  
F. BORTOLOTTI ◽  
C. FERRARO ◽  
M. MAJ
Keyword(s):  
Plasma Levels ◽  
Rating Scales ◽  
Low Frequency ◽  
Significant Negative Correlation ◽  
Plasma Prolactin ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Obsessive Compulsive Symptoms ◽  
Plasma Prl

Background. Abnormalities of brain serotonin (5-HT) transmission have been implicated in the pathophysiology of bulimia nervosa (BN), but no conclusive data have yet been provided. The purpose of this study was to assess 5-HT transmission via the measurement of the prolactin (PRL) response to the specific 5-HT releasing agent d-fenfluramine (d-FEN) in both patients with BN and comparison subjects.Methods. According to a double-blind placebo-controlled design, plasma PRL response to d-FEN was measured in 14 drug-free bulimics and 14 matched healthy controls. In both patients and controls, eating-related psychopathology, depressive and obsessive–compulsive symptoms, and aggressiveness were measured by rating scales.Results. Baseline plasma levels of PRL and 17β-oestradiol were significantly reduced in bulimic patients, whereas basal plasma levels of cortisol did not significantly differ from healthy controls. PRL response to d-FEN was not different between patients and controls as groups, but it was significantly blunted in bulimics with high frequency bingeing ([ges ]2 binge episodes per day; N=7) as compared to both those with low frequency bingeing ([les ]1 binge episode per day; N=7) and matched controls. A significant negative correlation emerged between the frequency of binge episodes and the hormone response to d-FEN. Moreover, although patients scored higher than healthy subjects on rating scales assessing depressive and obsessive–compulsive symptoms and aggressiveness, no significant correlation was found between these measures and the PRL response to d-FEN.Conclusions. These results support the idea that serotonin transmission is impaired in bulimic patients with frequent binge episodes.

Prolactin response to d-fenfluramine is blunted in people with anorexia nervosa

1998 ◽  
Vol 172 (5) ◽  
pp. 438-442 ◽  
Author(s):  
Palmiero Monteleone ◽  
Francesca Brambilla ◽  
Francesca Bortolotti ◽  
Antonietta La Rocca ◽  
Mario Maj
Keyword(s):  
Anorexia Nervosa ◽  
Rating Scales ◽  
Normal Weight ◽  
Plasma Prolactin ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Obsessive Compulsive Symptoms ◽  
Basal Cortisol ◽  
Healthy Control ◽  
Prolactin Response

BackgroundSeveral studies have explored serotonin (5-HT) transmission in people with anorexia nervosa, but their results have been inconsistent.MethodAccording to a double-blind placebo-controlled design, plasma prolactin response to the specific serotonergic probe d-fenfluramine was investigated in 10 underweight and two normal-weight women with anorexia, and in 12 age-matched healthy females. Eating-related psychopathology, depressive and obsessive-compulsive symptoms, and aggressiveness were measured by appropriate rating scales.ResultsCompared with healthy control subjects, the women with anorexia showed reduced baseline prolactin and oestrogen levels and increased basal Cortisol concentrations. The prolactin response to d-fenfluramine was blunted and did not correlate with psychopathological measures.ConclusionsThese results support a dysfunction of 5-HT transmission in anorexia nervosa. This dysfunction does not seem to be related to concomitant depressive or obsessive-compulsive symptoms or to the level of aggressiveness of the patients.

Prolactin response to d-fenfluramine in obsessive-compulsive patients, and outcome of fluvoxamine treatment

1997 ◽  
Vol 170 (6) ◽  
pp. 554-557 ◽  
Author(s):  
Palmiero Monteleone ◽  
Francesco Catapano ◽  
Stefania Dl Martino ◽  
Ciro Ferraro ◽  
Mario Maj
Keyword(s):  
Depressive Symptomatology ◽  
Plasma Prolactin ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Compulsive Disorder ◽  
Before And After ◽  
Prolactin Response ◽  
Drug Free

BackgroundAlthough several studies have directly explored serotonin (5-HT) transmission in patients with obsessive compulsive disorder (OCD), their results have been inconsistent and their clinical relevance is doubtfulMethodAccording to a double-blind placebo-controlled design, plasma prolactin (PRL) response to a specific serotonergic probe, d-fenfluramine, was measured in 20 drug-free obsessive compulsive patients and in 20 matched healthy controls. After the neuroendocrine test, 5 patients completed a lO-week treatment with fluvoxamine. Psychopathological assessment was performed before and after therapy.ResultsPRL response in OCD patients was blunted under the drug-free condition; correlated inversely with pretreatment ratings of obsessive-compulsive and depressive symptomatology; and correlated inversely with the improvement in obsessive-compulsivescore observed after fluvoxamine treatment.ConclusionsThese results support the idea of a dysfunction of 5-HT transmission in OCD, and suggest that the greater this impairment, the better the response to drugs which selectively block the reuptake of 5-HT.

Increased plasma kynurenine and its relationship to neopterin and tryptophan in Tourette's syndrome

1996 ◽  
Vol 26 (4) ◽  
pp. 857-862 ◽  
Author(s):  
H. Rickards ◽  
S. M. Dursun ◽  
G. Farrar ◽  
T. Betts ◽  
J. A. Corbett ◽  
...  
Keyword(s):  
Tourette Syndrome ◽  
Negative Correlation ◽  
Plasma Levels ◽  
Significant Positive Correlation ◽  
Significant Negative Correlation ◽  
Healthy Controls ◽  
Positive Correlation ◽  
Control Value ◽  
Cellular Immune ◽  
Patient Value

SynopsisFasting plasma levels of tryptophan, kynurenine and the pteridines, neopterin and tetrahydrobiopterin were measured in seven patients with Gilles de la Tourette syndrome (GTS) and 10 healthy controls. Plasma kynurenine was significantly elevated in the GTS patients. The lowest patient value was higher than the highest control value. Values for tryptophan, neopterin and tetrahydrobiopterin were similar in TS patients and controls. However, in TS patients only, there was a significant negative correlation between tryptophan and neopterin and a significant positive correlation between kynurenine and neopterin when controlling for tryptophan. This finding indicates that activation of cellular immune processes is a possible explanation for the rise in plasma kynurenine.

Severity of Obsessive-Compulsive Symptoms is Related to Self-Directedness Character Trait in Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2004 ◽  
Vol 9 (8) ◽  
pp. 607-612 ◽  
Author(s):  
Carlos Cruz-Fuentes ◽  
Claudia Blas ◽  
Laura Gonzalez ◽  
Beatriz Camarena ◽  
Humberto Nicolini
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Rating Scales ◽  
Character Trait ◽  
Depression And Anxiety ◽  
Temperament And Character Inventory ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Behavioral Features ◽  
Character Inventory

ABSTRACT:Objective:The present study examined the psychobiological Temperament and Character model of personality on obsessive-compulsive disorder (OCD) patients, as well as the relation of temperament and/or character dimensions on the severity of obsessive-compubive symptoms.Methods:Fifty-four subjects diagnosed with OCD, were assessed with the Temperament and Character Inventory, the Yale-Brown Obsessive-Compulsive scale and the Hamilton Rating Scales for depression and anxiety.Results:Compared with controls, OCD subjects displayed increased harm avoidance and lower self-directedness and cooperativeness. Low self-directedness and high Hamilton depression scores were associated with increased severity of obsessive-compulsive symptoms.Conclusions:The Temperament and Character profile of OCD patients characterized in the present stud personality model and can be linked to some of their behavioral features. Furthermore, our data provides support of the influence that some personality traits may have on the severity of OCD symptoms.

A Double-Blind Comparison of Lithium Carbonate and Maprotiline in the Prophylaxis of the Affective Disorders

1976 ◽  
Vol 128 (5) ◽  
pp. 479-485 ◽  
Author(s):  
Alec Coppen ◽  
S. A. Montgomery ◽  
R. K. Gupta ◽  
J. E. Bailey
Keyword(s):  
Plasma Levels ◽  
Affective Disorders ◽  
Lithium Carbonate ◽  
Significant Negative Correlation ◽  
High Plasma ◽  
Double Blind ◽  
Dosage Regime ◽  
Blind Comparison ◽  
One Year ◽  
Morbidity Index

SummaryA double-blind prospective study was carried out comparing the prophylactic effect of maprotiline and lithium carbonate over a period of one year in patients suffering from recurrent affective disorders. The average Affective Morbidity Index was lower, but not significantly so, in patients treated with lithium. A further analysis, based on dividing patients into those with no affective morbidity and those who showed some affective morbidity during the study, demonstrated lithium carbonate to be significantly superior to maprotiline both in the group as a whole and in unipolar depressives. A correlation between high plasma maprotiline concentration and low morbidity was observed and was in line with an earlier report. A highly significant negative correlation (r = −0.97; p < 0.001) was found between plasma maprotiline concentration and body weight. Although the results showed lithium carbonate to be superior to maprotiline in the study, it should be emphasized that the plasma levels of lithium were constantly monitored and maintained at what is considered to be its optimum concentration, whereas the maprotiline treated patients were kept on a fixed dosage regime irrespective of plasma levels.

Does Magical Thinking Improve Across Treatment For Obsessive–Compulsive Disorder?

2008 ◽  
Vol 25 (3) ◽  
pp. 149-155 ◽  
Author(s):  
Danielle A. Einstein ◽  
Ross G. Menzies
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Significant Negative Correlation ◽  
Short Version ◽  
Magical Thinking ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
Poor Prognostic Factor ◽  
Magical Ideation ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder

AbstractThe present study investigated whether MI is a mechanism for change in the treatment of obsessive–compulsive disorder (OCD). The Magical Ideation scale (MI), the Obsessive–Compulsive Inventory — Short Version (OCI-SV) and the Padua Inventory were completed by 34 obsessive–compulsive patients pre- and post cognitive–behavioural treatment. Treatment did not target magical styles of thinking. Significant improvements on all three measures of obsessive–compulsive symptoms were demonstrated by t tests over the course of treatment. Improvement in magical thinking was also shown to be significant in t test results. In support of the hypothesis, correlations between MI improvement and improvement on the obsessive–compulsive symptom scales were significant (at a level of .05) suggesting that there is an association between improvement in magical thinking and improvement in obsessive–compulsive symptoms. Notably, a significant negative correlation was obtained between prescores on MI and change scores on the OCD measures. This suggests that high levels of MI are associated with high levels of treatment intractability. High MI appears to be a poor prognostic factor in OCD.

scholarly journals Prader–Willi syndrome, compulsive and ritualistic behaviours: the first population-based survey

2002 ◽  
Vol 180 (4) ◽  
pp. 358-362 ◽  
Author(s):  
D. J. Clarke ◽  
H. Boer ◽  
J. Whittington ◽  
A. Holland ◽  
J. Butler ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Rating Scales ◽  
Structured Interview ◽  
Population Based ◽  
Control Group ◽  
Prader Willi Syndrome ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Population Based Survey

BackgroundObsessive–compulsive disorder has been reported in association with Prader–Willi syndrome.AimsTo report the nature and prevalence of compulsive and similar symptoms associated with Prader–Willi syndrome in a population ascertained as completely as possible.MethodAttempted complete ascertainment of people with Prader– Willi syndrome in eight English counties. Administration of standardised rating scales and a structured interview. Comparison with people with learning disability and high body mass indices.ResultsPrader–Willi syndrome was associated with high rates of ritualistic behaviours, such as the need to ask or to tell something, insistence on routines, hoarding and ordering objects and repetitive actions and speech, compared with the control group, and was negatively correlated with IQ and socialisation age. Typical obsessive–compulsive symptoms, such as checking, counting and cleaning compulsions or obsessional thoughts, were not found.ConclusionsRitualistic and compulsive behaviours occur more frequently in association with Prader–Willi syndrome than among people with intellectual disability and significant obesity.

Efficacy of Drug Treatment in Obsessive–Compulsive Disorder: a Meta-Analytic Review

1995 ◽  
Vol 166 (4) ◽  
pp. 424-443 ◽  
Author(s):  
Marco Piccinelli ◽  
Stefano Pini ◽  
Cesario Bellantuono ◽  
Greg Wilkinson
Keyword(s):  
Drug Treatment ◽  
Obsessive Compulsive Disorder ◽  
Therapeutic Efficacy ◽  
Antidepressant Drugs ◽  
Physical Symptoms ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Improvement Rate ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder

BackgroundA review of the efficacy of antidepressant drug treatment in patients with obsessive–compulsive disorder (OCD), using a meta-analytic approach.MethodRandomised double-blind clinical trials of antidepressant drugs, carried out among patients with OCD and published in peer-reviewed journals between 1975 and May 1994, were selected together with three studies currently in press. Forty-seven trials were located by searching the Medline and Excerpta Medica – Psychiatry data bases, scanning psychiatric and psychopharmacological journals, consulting recent published reviews and bibliographies, contacting pharmaceutical companies and through cross-references. Hedges' g was computed in pooled data at the conclusion of treatment under double-blind conditions or at the latest reported point of time during this treatment period. For each trial, effect sizes were computed for all available outcome measures of the following dependent variables: obsessive–compulsive symptoms considered together; obsessions; compulsions; depression; anxiety; global clinical improvement; psychosocial adjustment; and physical symptoms.ResultsClomipramine was superior to placebo in reducing both obsessive–compulsive symptoms considered together (g = 1.31; 95% CI = 1.15 to 1.47) as well as obsessions (g = 0.89, 95% CI = 0.36 to 1.42) and compulsions (g = 0.79; 95% CI = 0.34 to 1.24) taken separately. Also, selective serotonin re-uptake inhibitors (SSRIs) as a class were superior to placebo, weighted mean g being respectively 0.47 (95% CI = 0.33 to 0.61), 0.54 (95% CI = 0.34 to 0.74) and 0.52 (95% CI = 0.34 to 0.70) for obsessive–compulsive symptoms considered together, and obsessions and compulsions taken separately. Although on Y–BOCS the increase in improvement rate over placebo was 61.3%, 28.5%, 28.2% and 21.6% for clomipramine, fluoxetine, fluvoxamine, and sertraline respectively, the trials testing clomipramine against fluoxetine and fluvoxamine showed similar therapeutic efficacy between these drugs. Finally, both clomipramine and fluvoxamine proved superior to antidepressant drugs with no selective serotonergic properties.ConclusionAntidepressant drugs are effective in the short-term treatment of patients suffering from OCD; although the increase in improvement rate over placebo was greater for clomipramine than for SSRIs, direct comparison between these drugs showed that they had similar therapeutic efficacy on obsessive–compulsive symptoms; clomipramine and fluvoxamine had greater therapeutic efficacy than antidepressant drugs with no selective serotonergic properties; concomitant high levels of depression at the outset did not seem necessary for clomipramine and for SSRIs to improve obsessive–compulsive symptoms.

scholarly journals Fenfluramine Challenge Test in Obsessive-Compulsive Disorder - First Results

1997 ◽  
Vol 40 (4) ◽  
pp. 99-102
Author(s):  
Vladimír Pidrman ◽  
Ivan Tůma
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Challenge Test ◽  
Significant Negative Correlation ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Gastrointestinal Problems ◽  
First Results ◽  
Prolactin Response ◽  
Treatment Alternatives

Obsessive-compulsive disorder is a chronic psychiatric illness, affecting up to 3% of the general population, to the midle of 60-th it was supposed to be untreatable. Antidepressant pharmacotherapy is one of the treatment alternatives today. We compared efficacy and safety of citalopram versus clomipramine (serotoninergic antidepressants) in 6 weeks in double blind therapy of obsessive-compulsive disorder. The second objective was to compare prolactin response to a fenfluramine challenge test before the treatment of patients and after 6 weeks of the treatment. In a sample of 14 patients we confirmed significant therapeutic response after 3 weeks of pharmacoterapy, better in obsession than in compulsion. We found low level of adverse effects in the first week of therapy - dry mouth, anxiety, nausea, somnolence, tremor, and sexual adverse events. There were no changes in the laboratory, test EEG, and ECG examinations. Fenfluramine challenge test showed statistically significant decrease of prolactine levels 1 hour after administration of fenfluramine. It was not observed after six weeks of the therapy. Statistically significant negative correlation between prolactine plasma levels at the 6-th hour after administration of fenfluramine and obsession item of YBOC Scale was showed after the 3-rd and 6-th week of the therapy. The correlation was not observed for compulsion item YBOC Scale. Side effects observed during and after the challenge test were anxiety and nervousness and gastrointestinal problems, lasted from l hour to 10 hours. These preliminary result could support the idea, that obsessions and compulsions have not necessary the same biological background. The challenge paradigm appears to be a possible way to clarify the pathogenesis of OCD. Our study will continue.

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