Sallee F R, Vrindavanam N S, Deas-Nesmith D, Odom A M, Carson S W, Sethuraman G
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29403, USA.
Biol Psychiatry. 1998 Oct 1;44(7):562-7. doi: 10.1016/s0006-3223(97)00447-2.
Major depressive disorder (MDD) in the adolescent demonstrates a unique clinical profile, and pathogenic serotonergic dysregulation is hypothesized. Parenteral clomipramine (CMI) is known to distinguish adult MDD from control, but neurochallenge data are lacking in adolescent MDD.
Thirteen drug-free outpatient adolescents who met DSM-III-R criteria for MDD were compared to adolescent controls by acute neuroendocrine and mood response to 12.5 mg of parenteral CMI.
Repeated measures analysis revealed significant changes from baseline for sadness (p < .01) between groups, with normal controls increasing sadness rating after CMI. Prolactin (PRL) maximum change score from baseline was decreased in MDD relative to controls (p < .05). Gender effects on PRL were evident in controls but not in MDD.
The findings of PRL blunting in adolescent MDD mirrors previous work in adults. A unique finding is the induction of sadness in normal adolescent controls after CMI infusion.
青少年重度抑郁症（MDD）表现出独特的临床特征，并且推测存在致病性血清素调节异常。已知胃肠外氯米帕明（CMI）可区分成人MDD与对照组，但青少年MDD缺乏神经激发试验数据。
通过对12.5mg胃肠外CMI的急性神经内分泌和情绪反应，将13名符合DSM-III-R标准的无药物治疗门诊青少年MDD患者与青少年对照组进行比较。
重复测量分析显示，两组之间悲伤程度与基线相比有显著变化（p < 0.01），正常对照组在使用CMI后悲伤评分增加。与对照组相比，MDD组中催乳素（PRL）相对于基线的最大变化分数降低（p < 0.05）。PRL的性别效应在对照组中明显，但在MDD组中不明显。
青少年MDD中PRL反应迟钝的发现与先前在成人中的研究结果相似。一个独特的发现是，在输注CMI后，正常青少年对照组会出现悲伤情绪。
