Dollfus S, Petit M, Launay J M, Callebert J, Boudou P, Dreux C, Ménard J F
CHS du Rouvray, Service Hospitalo-Universitaire, Sotteville-les-Rouen.
Encephale. 1992 Nov-Dec;18(6):605-10.
In infantile autism, the serotoninergic (5-HT) hypothesis is corroborated by biological dosages and therapeutic effects of fenfluramine which decrease blood serotonin. However other drugs, such as dopaminergic agonists or antagonists, have therapeutic effects. Therefore, we tested the hypothesis that two dopaminergic (DA) drugs have a similar 5-HT effect underlying the therapeutic efficiency. We evaluated in a randomized, double-blind and cross-over study, the effects of a DA agonist (bromocriptine) and a DA antagonist (amisulpride) on platelet 5-HT in infantile autism. The prolactinemia, reflecting the DA action, has been also measured. Nine children, aged from 4 to 13 years, according to the DSM III for infantile autism, received either drug in a random order during four weeks with an in-between placebo period of six weeks. The dosages of platelet 5-HT and serum prolactin were carried out at the beginning and at the end of every phase of treatment (active or placebo) with radioenzymology and radioimmunoassay methods respectively. The principal results on serum prolactin show neither order x treatment interaction, nor order effect but a significant treatment effect (p < 0.01): amisulpride increases serum prolactin whereas bromocriptine decreases according to the usual data. About platelet 5-HT, there is neither order x treatment interaction, nor treatment effect but a significant order effect (p < 0.01). Both drugs increase platelet 5-HT in the first phase of treatment. This order effect could be explained by a remanent effect of amisulpride after 6 wash-out weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
在婴儿自闭症中,血清素能(5-羟色胺,5-HT)假说得到了能降低血液血清素的芬氟拉明的生物学剂量及治疗效果的证实。然而,其他药物,如多巴胺能激动剂或拮抗剂,也有治疗效果。因此,我们检验了这样一个假说:两种多巴胺能(DA)药物在治疗效果背后具有相似的5-HT效应。我们在一项随机、双盲和交叉研究中,评估了一种DA激动剂(溴隐亭)和一种DA拮抗剂(氨磺必利)对婴儿自闭症患者血小板5-HT的影响。同时也测量了反映DA作用的催乳素血症。根据《精神疾病诊断与统计手册》第三版(DSM III)诊断为婴儿自闭症的9名4至13岁儿童,在四周内随机服用其中一种药物,中间有六周的安慰剂期。分别采用放射酶法和放射免疫分析法在每个治疗阶段(活性药物或安慰剂)开始和结束时测定血小板5-HT和血清催乳素的剂量。关于血清催乳素的主要结果显示,既没有顺序×治疗的交互作用,也没有顺序效应,但有显著的治疗效应(p<0.01):根据通常数据,氨磺必利会增加血清催乳素,而溴隐亭会降低血清催乳素。关于血小板5-HT,既没有顺序×治疗的交互作用,也没有治疗效应,但有显著的顺序效应(p<0.01)。两种药物在治疗的第一阶段都会增加血小板5-HT。这种顺序效应可以用在六周洗脱期后氨磺必利的残留效应来解释。(摘要截选至250字)