Smedh K, Spigset O, Allard P, Mjörndal T, Adolfsson R
Department of Psychiatry, Umeå Universitet, Sweden.
Biol Psychiatry. 1999 Feb 15;45(4):464-70. doi: 10.1016/s0006-3223(98)00069-9.
Seasonal affective disorder (SAD) has been regarded as a melatonin disorder, but the pathophysiological mechanisms of SAD are to a large extent unclarified. Serotonergic mechanisms have also been studied, but they have shown inconsistent results.
We have compared [3H]paroxetine and [3H]lysergic acid diethylamide (LSD) binding in platelets from 23 SAD patients and 23 controls. Then SAD patients had 4 weeks of light therapy. On the last treatment day new blood samples were drawn. Symptoms before and after light treatment were measured by SIGH-SAD.
Bmax for paroxetine binding before light treatment was higher in SAD patients compared to controls and also higher in responders than in nonresponders. Bmax decreased significantly during light treatment. We also found a negative correlation between the two Bmax values before but not after light treatment. There was a negative correlation between Bmax for paroxetine binding before treatment and clinical status after treatment. Patients with reduced Bmax for LSD binding after treatment had a better clinical treatment response.
The present study indicates that serotonin receptor parameters might be suitable in the prediction of clinical response to light treatment.
季节性情感障碍(SAD)被认为是一种褪黑素紊乱疾病,但SAD的病理生理机制在很大程度上仍未阐明。血清素能机制也已得到研究,但结果并不一致。
我们比较了23例SAD患者和23例对照者血小板中[3H]帕罗西汀和[3H]麦角酸二乙酰胺(LSD)的结合情况。然后,SAD患者接受了4周的光照疗法。在最后一个治疗日采集新的血样。通过SIGH-SAD量表测量光照治疗前后的症状。
与对照者相比,SAD患者在光照治疗前帕罗西汀结合的最大结合容量(Bmax)更高,且反应者的Bmax高于无反应者。光照治疗期间Bmax显著降低。我们还发现光照治疗前两个Bmax值之间存在负相关,而光照治疗后则不存在。治疗前帕罗西汀结合的Bmax与治疗后的临床状态之间存在负相关。治疗后LSD结合的Bmax降低的患者临床治疗反应更好。
本研究表明,血清素受体参数可能适用于预测光照治疗的临床反应。