Mitchell P, Smythe G
School of Psychiatry, University of New South Wales, Sydney, Australia.
J Affect Disord. 1990 May;19(1):43-51. doi: 10.1016/0165-0327(90)90008-v.
To investigate central neurotransmitter function in depression, baseline levels of serum cortisol and prolactin and the responses of these hormones to the putative serotonin agonist fenfluramine (60 mg, oral) were examined in 27 depressed patients and 14 normal subjects. Baseline cortisol was significantly elevated (P less than 0.01) in depressed subjects, whilst baseline prolactin was significantly reduced (P = 0.01) after covarying for cortisol. Although there were no significant abnormalities in either the prolactin or the cortisol response to fenfluramine in the total depressed group, the peak increase in prolactin levels (delta PRL) was significantly reduced (P less than 0.05) in subjects with endogenous depression. Analysis of covariance demonstrated, however, that the reduced delta PRL was partially dependent upon the abnormal baseline prolactin and cortisol levels. These results indicate the necessity of accounting for these baseline effects when investigating hormonal responses to the putative serotonergic challenges. The abnormal baseline findings are consistent with increased central noradrenergic activity in depression.
为研究抑郁症患者中枢神经递质功能，对27例抑郁症患者和14名正常受试者检测了血清皮质醇和催乳素的基础水平，以及这些激素对假定的5-羟色胺激动剂芬氟拉明（60mg，口服）的反应。抑郁症患者的基础皮质醇水平显著升高（P<0.01），而在对皮质醇进行协变量校正后，基础催乳素水平显著降低（P=0.01）。虽然在整个抑郁症组中，催乳素或皮质醇对芬氟拉明的反应均无显著异常，但内源性抑郁症患者催乳素水平的峰值升高（△PRL）显著降低（P<0.05）。然而，协方差分析表明，△PRL降低部分取决于异常的基础催乳素和皮质醇水平。这些结果表明，在研究激素对假定的5-羟色胺激发试验的反应时，有必要考虑这些基础效应。基础水平异常的结果与抑郁症患者中枢去甲肾上腺素能活性增加一致。
