Lack of effect of HPA axis hyperactivity on hormonal responses to d-fenfluramine in major depressed patients: implications for pathogenesis of suicidal behaviour

被引:37
作者
Duval, F
Mokrani, MC
Correa, H
Bailey, P
Valdebenito, M
Monreal, J
Crocq, MA
Macher, JP
机构
[1] Ctr Hosp, F-68250 Rouffach, France
[2] Inst Res Neurosci & Psychiat, FORENAP, Rouffach, France
[3] Univ Fed Minas Gerais, Inst Biol Sci, Dept Pharmacol, Belo Horizonte, MG, Brazil
关键词
DST; d-fenfluramine; major depression; suicide; prolactin; ACTH; cortisol;
D O I
10.1016/S0306-4530(01)00011-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
There is evidence for inhibitory effects of adrenocorticosteroids on serotonergic (5-HT) activity. However, in depression the relationship between altered cortisol levels and brain 5-HT function remains to be clarified. The aim of this study was to investigate whether hypothalamic-pituitary-adrenal (HPA) axis hyperactivity is associated with 5-HT dysfunction in depressed patients, especially in those with suicidal behaviour. Cortisol levels following the dexamethasone suppression test (DST, 1 mg PO) and prolactin, corticotropin and cortisol responses to the d-fenfluramine test (d-FEN, 45 mg PO)- a specific 5-HT releaser/uptake inhibitor - were measured in 71 drug-free DSM-IV major depressed inpatients (40 with a history of suicide attempt, 31 without) and 34 hospitalized healthy control sujects. Depressed patients showed higher post-DST cortisol levels but similar responses to d-FEN compared with control subjects. Hormonal responses to d-FEN were not correlated with cortisol levels (basal or post-DST). Among the depressed patients, DST suppressors and DST nonsuppressors exhibited no significant difference in endocrine responses to d-FEN. However, patients with a history of suicide attempt, when compared with patients without such a history, showed lower hormonal responses to d-FEN but comparable basal and post-DST cortisol levels. Taken together these results suggest that, in depression, HPA axis hyperactivity is not responsible for the reduced 5-HT activity found in patients with a history of suicidal behavior. (C) 2001 Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:521 / 537
页数:17
相关论文
共 78 条
[51]   Diagnostic and Statistical Manual of Mental Disorders [J].
Mittal, Vijay A. ;
Walker, Elaine F. .
PSYCHIATRY RESEARCH, 2011, 189 (01) :158-159
[52]   DEXAMETHASONE SUPPRESSION TEST (DST) IN RELATION TO DEPRESSIVE SOMATIC AND SUICIDAL MANIFESTATIONS [J].
MODESTIN, J ;
RUEF, C .
ACTA PSYCHIATRICA SCANDINAVICA, 1987, 75 (05) :491-494
[53]   MULTIHORMONAL RESPONSES TO APOMORPHINE IN MENTAL-ILLNESS [J].
MOKRANI, MC ;
DUVAL, F ;
CROCQ, MA ;
BAILEY, PE ;
MACHER, JP .
PSYCHONEUROENDOCRINOLOGY, 1995, 20 (04) :365-375
[54]  
Mokrani MC, 1997, PSYCHONEUROENDOCRINO, V22, pS63
[55]   DST studies in psychotic depression: A meta-analysis [J].
Nelson, JC ;
Davis, JM .
AMERICAN JOURNAL OF PSYCHIATRY, 1997, 154 (11) :1497-1503
[56]   THE DEXAMETHASONE SUPPRESSION TEST AND COMPLETED SUICIDE [J].
NORMAN, WH ;
BROWN, WA ;
MILLER, IW ;
KEITNER, GI ;
OVERHOLSER, JC .
ACTA PSYCHIATRICA SCANDINAVICA, 1990, 81 (02) :120-125
[57]  
OKEANE V, 1991, AM J PSYCHIAT, V148, P1009
[58]   EVIDENCE FOR 5-HYDROXYTRYPTAMINE(1A) RECEPTOR INVOLVEMENT IN THE CONTROL OF PROLACTIN SECRETION IN MAN [J].
PALAZIDOU, E ;
STEPHENSON, J ;
BUTLER, J ;
COSKERAN, P ;
CHAMBERS, S ;
MCGREGOR, AM .
PSYCHOPHARMACOLOGY, 1995, 119 (03) :311-314
[59]   5-HT neuroendocrine function in major depression: Prolactin and cortisol responses to D-fenfluramine [J].
Park, SBG ;
Williamson, DJ ;
Cowen, PJ .
PSYCHOLOGICAL MEDICINE, 1996, 26 (06) :1191-1196
[60]   EFFECT OF PINDOLOL ON THE PROLACTIN RESPONSE TO D-FENFLURAMINE [J].
PARK, SBG ;
COWEN, PJ .
PSYCHOPHARMACOLOGY, 1995, 118 (04) :471-474