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

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.

Download Full-text

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

Psychological Medicine ◽

10.1017/s0033291798006904 ◽

1998 ◽

Vol 28 (4) ◽

pp. 975-983 ◽

Cited By ~ 21

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.

Download Full-text

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

The British Journal of Psychiatry ◽

10.1192/bjp.170.6.554 ◽

1997 ◽

Vol 170 (6) ◽

pp. 554-557 ◽

Cited By ~ 13

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.

Download Full-text

Serotonin Dysfunction in Pathological Gamblers: Increased Prolactin Response to Oral m-CPP Versus Placebo

CNS Spectrums ◽

10.1017/s1092852900015145 ◽

2006 ◽

Vol 11 (12) ◽

pp. 956-965 ◽

Cited By ~ 27

Author(s):

Stefano Pallanti ◽

Silvia Bernardi ◽

Leonardo Quercioli ◽

Concetta DeCaria ◽

Eric Hollander

Keyword(s):

Clinical Severity ◽

Acute Administration ◽

Double Blind ◽

Pathological Gamblers ◽

Healthy Control ◽

Cortisol Responses ◽

Gambling Severity ◽

Prolactin Response ◽

The Relationship

ABSTRACTObjectiveAcute administration of the partial serotonin (5-HT) agonist meta-chlorophenylpi-perazine (m-CPP), that is used also as a street drug, has been reported to induce a “high” and craving response in various impulsive and sub-stance addiction disorders.IntroductionTo clarify altered 5-HT metabolism in pathological gamblers and to explore the specific role of serotonergic system in non substance addictions, we assessed behavioral (“high” and “craving”) and neuroendocrine (prolactin and cortisol) responses to an oral single dose of m-CPP and placebo in pathological gamblers and matched controls. Moreover, the relationship between neuroendocrine outcome and clinical severity has been assessed.MethodTwenty-six pathological gamblers and 26 healthy control subjects enter a double-blind, placebo-controlled-crossed administration of orally dose m-CPP 0.5 mg/kg. Outcome measures included prolactin and cortisol levels, gambling severity, mood, craving and “high” scales.ResultsPathological gamblers had significantly increased prolactin response compared to controls at 180 minutes and at 210 minutes post–administration. Greater pathological gamblers severity correlated with increased neuroendocrine responsiveness to m-CCP, suggesting greater 5-HT dysregulation. Pathological gambling patients had a significantly increased “high” sensation after m-CPP administration compared with control.ConclusionThese results provide additional evidence for 5-HT disturbance in pathological gamblers and they support the hypotheses that the role of the 5-HT dysfunction related to the experience of “high” might represent the path-way that leads to dyscontrolled behavior in patho-logical gamblers. Furthermore, the “high” feeling induced by m-CPP in pathological subjects may represent a marker of vulnerability to both behav-ioral and substance addictions.

Download Full-text

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

CNS Spectrums ◽

10.1017/s1092852900002789 ◽

2004 ◽

Vol 9 (8) ◽

pp. 607-612 ◽

Cited By ~ 17

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.

Download Full-text

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

The British Journal of Psychiatry ◽

10.1192/bjp.180.4.358 ◽

2002 ◽

Vol 180 (4) ◽

pp. 358-362 ◽

Cited By ~ 102

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.

Download Full-text

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

The British Journal of Psychiatry ◽

10.1192/bjp.166.4.424 ◽

1995 ◽

Vol 166 (4) ◽

pp. 424-443 ◽

Cited By ~ 174

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.

Download Full-text

Exploring the Relationship between Obsessive-compulsive Characteristics and Symptoms of Eating Disorders in a Nonclinical Population

World Journal of Social Science ◽

10.5430/wjss.v7n1p25 ◽

2020 ◽

Vol 7 (1) ◽

pp. 25

Author(s):

John Paulson

Keyword(s):

Anorexia Nervosa ◽

Self Report ◽

Clinical Samples ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

College Sample ◽

Eating Disorder Symptoms ◽

The One ◽

The Relationship

Previous research has documented similarities between symptoms of Obsessive-Compulsive Disorder (OCD), Anorexia Nervosa, and Bulimia Nervosa and elevated comorbidity between these conditions in clinical samples, with the relationship between OCD and Anorexia being stronger than between OCD and Bulimia. Researchers adopting a continuum view of psychopathology have also found that individuals with sub-clinical expressions of obsessive-compulsive symptoms resemble their clinical counterparts in several ways. The goal of the current study was to explore whether or not the observed relationship between obsessive-compulsive symptoms and eating disorder symptoms observed in clinical populations would also be observed in a nonclinical population. 264 participants from a college sample completed self-report measures of these symptoms. A positive correlation was found between scores on obsessive-compulsive, anorexia and bulimia instruments, and reflective of their clinical counterparts the relationship between obsessive-compulsive and anorexia symptoms was more significant than the one between obsessive compulsive symptoms and bulimia symptoms. Implications and limitations for research and clinical practice are discussed.

Download Full-text

Fenfluramine Challenge Test in Obsessive-Compulsive Disorder - First Results

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2020.53 ◽

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.

Download Full-text