Delayed obsessive compulsive disorder symptom exacerbation after a single dose of a serotonin antagonist in fluoxetine-treated but not untreated patients

被引：29

作者：

Greenberg, DB ^{[1
]}

Benjamin, J ^{[1
]}

Martin, JD ^{[1
]}

Keuler, D ^{[1
]}

Huang, SJ ^{[1
]}

Altemus, M ^{[1
]}

Murphy, DL ^{[1
]}

机构：

[1] NIMH, Clin Sci Lab, Bethesda, MD 20892 USA

来源：

PSYCHOPHARMACOLOGY | 1998年 / 140卷 / 04期

关键词：

obsessive-compulsive disorder; anxiety; serotonin reuptake inhibitor; serotonin antagonist; metergoline; fluoxetine;

D O I：

10.1007/s002130050787

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Enhanced serotonergic transmission may underlie therapeutic effects of serotonin reuptake inhibitors in obsessive-compulsive disorder. However, such treatment may decrease serotonin receptor responsivity. We investigated whether the serotonin antagonist metergoline would exacerbate or further improve systems in fluoxetine-responsive patients. Pilot results suggested open metergoline produced delayed symptom worsening in fluoxetine-treated patients. Fourteen patients continuing fluoxetine received metergoline and placebo (double-blind, randomized). Symptom ratings continued for 1 week afterwards. Ten unmedicated patients underwent the same procedures. Symptoms improved 4 h after both metergoline and placebo. The day after metergoline but not placebo, fluoxetine-treated patients had significantly increased anxiety, obsessions and compulsions, abating over several days. Depression was unchanged. Metergoline had no similar delayed effects in unmedicated patients. Metergoline levels were higher in fluoxetine-treated patients. These results, consistent with less conclusive earlier findings, suggest that prolonged changes in brain serotonin function underlie symptom re-emergence following administration of metergoline to fluoxetine-treated patients with obsessive-compulsive disorder.

引用

页码：434 / 444

页数：11

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