Section on Clinical Pharmacology, Clinical Neuroscience Branch, National Institute of Mental Health, Bethesda, MD 20892, USA.
J Psychopharmacol. 1992 Jan;6(4):501-8. doi: 10.1177/026988119200600405.
We prospectively investigated the effects of a course of electroconvulsive therapy (ECT) on neuroendocrine responses to serotonergic challenge in five depressed patients. Low dose intravenous chlorimipramine (CMI) challenge produced a modest release of prolactin and significant increases in plasma adrenocorticotrophic hormone (ACTH) and cortisol. Interestingly, ECT did not alter the neuroendocrine responses to serotonergic challenge despite clinical response in four of the five patients. If anything, the modest prolactin (PRL) response to CMI, rather than being enhanced, appeared to be abolished following ECT. Using confidence intervals, we estimate that there is less than a 5% probability of a 78% increase in prolactin response to CMI after ECT. To detect this, a sample size of greater than 35 would be needed. These findings suggest that neither ECT nor the clinical response in severely depressed patients is likely to produce consistent changes in neuroendocrine response to the acute serotonergic effects of CMI infusion. The lack of effect of ECT on prolactin response to serotonergic challenge might be explained by simultaneous enhancement of both serotonergic and dopaminergic neurotransmission.
我们前瞻性地研究了电惊厥疗法（ECT）对五名抑郁患者的 5-羟色胺能刺激反应的神经内分泌的影响。低剂量静脉注射氯米帕明（CMI）刺激产生了催乳素适度释放，并显著增加了促肾上腺皮质激素（ACTH）和皮质醇的水平。有趣的是，尽管五名患者中的四名临床反应良好，但 ECT 并未改变对 5-羟色胺能刺激的神经内分泌反应。如果有的话，ECT 后，CMI 引起的适度催乳素（PRL）反应似乎被消除，而不是增强。我们使用置信区间估计，ECT 后，CMI 引起的催乳素反应增加 78%的概率小于 5%。为了检测到这一点，需要大于 35 的样本量。这些发现表明，ECT 或严重抑郁患者的临床反应都不太可能导致对 CMI 输注的急性 5-羟色胺能作用的神经内分泌反应产生一致变化。ECT 对催乳素对 5-羟色胺能刺激反应无影响，这可能是由于同时增强了 5-羟色胺能和多巴胺能神经传递。
