Lichtenberg P, Shapira B, Gillon D, Kindler S, Cooper T B, Newman M E, Lerer B
Herzog Hospital-Ezrath Nashim, Israel.
Psychiatry Res. 1992 Aug;43(2):137-46. doi: 10.1016/0165-1781(92)90128-p.
Plasma prolactin and cortisol levels after oral administration of d-l fenfluramine hydrochloride (60 mg) and placebo were examined in 24 endogenously depressed patients and 21 age- and sex-matched normal control subjects in a randomized, double-blind study. Prolactin levels were significantly increased by fenfluramine in both groups, but the response was significantly blunted in the depressed patients compared with the controls. This effect was partially dependent upon elevated baseline cortisol levels in the depressed group and was also influenced by a history of weight loss. Plasma cortisol levels were not increased by fenfluramine in either group. These findings confirm previous reports and suggest that patients with endogenous major depression are characterized by central serotonergic hyporesponsivity. The need to account for baseline effects on hormonal responses to putative serotonergic agents is supported by the findings; however, these effects appear to be less striking when endogenicity is a prominent clinical feature of the depressive syndrome. The apparently complex influence of weight loss on prolactin response to serotonergic challenge remains to be clarified as well as the role played by the bioavailability of the challenge drug and its metabolite.
在一项随机、双盲研究中，对24名内源性抑郁症患者和21名年龄及性别匹配的正常对照者口服盐酸d - l芬氟拉明（60毫克）和安慰剂后的血浆催乳素和皮质醇水平进行了检测。两组中芬氟拉明均使催乳素水平显著升高，但与对照组相比，抑郁症患者的反应明显减弱。这种效应部分取决于抑郁症组基线皮质醇水平的升高，并且还受到体重减轻史的影响。两组中芬氟拉明均未使血浆皮质醇水平升高。这些发现证实了先前的报道，并表明内源性重度抑郁症患者的特征是中枢血清素能反应低下。这些发现支持了在评估假定血清素能药物的激素反应时需要考虑基线效应的观点；然而，当内源性是抑郁综合征的突出临床特征时，这些效应似乎不那么明显。体重减轻对血清素能激发试验催乳素反应的明显复杂影响以及激发药物及其代谢物的生物利用度所起的作用仍有待阐明。
