Psychopharmacology

, Volume 140, Issue 4, pp 434–444

Delayed obsessive-compulsive disorder symptom exacerbation after a single dose of a serotonin antagonist in fluoxetine-treated but not untreated patients

  • B. D. Greenberg
  • Jonathan Benjamin
  • Juliet D. Martin
  • David Keuler
  • S.-J. Huang
  • Margaret Altemus
  • Dennis L. Murphy
ORIGINAL INVESTIGATION

DOI: 10.1007/s002130050787

Cite this article as:
Greenberg, B., Benjamin, J., Martin, J. et al. Psychopharmacology (1998) 140: 434. doi:10.1007/s002130050787

Abstract

Enhanced serotonergic transmission may underlie therapeutic effects of serotonin reuptake inhibitors in obsessive-compulsive disorder. However, such treatment may decrease serotonin receptor responsivity. We investigated whether the serotonin antagonist metergoline would exacerbate or further improve systems in fluoxetine-responsive patients. Pilot results suggested open metergoline produced delayed symptom worsening in fluoxetine-treated patients. Fourteen patients continuing fluoxetine received metergoline and placebo (double-blind, randomized). Symptom ratings continued for 1 week afterwards. Ten unmedicated patients underwent the same procedures. Symptoms improved 4 h after both metergoline and placebo. The day after metergoline but not placebo, fluoxetine-treated patients had significantly increased anxiety, obsessions and compulsions, abating over several days. Depression was unchanged. Metergoline had no similar delayed effects in unmedicated patients. Metergoline levels were higher in fluoxetine-treated patients. These results, consistent with less conclusive earlier findings, suggest that prolonged changes in brain serotonin function underlie symptom re-emergence following administration of metergoline to fluoxetine-treated patients with obsessive-compulsive disorder.

Key words Obsessive-compulsive disorder Anxiety Serotonin reuptake inhibitor Serotonin antagonist Metergoline Fluoxetine 

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • B. D. Greenberg
    • 1
  • Jonathan Benjamin
    • 1
  • Juliet D. Martin
    • 1
  • David Keuler
    • 1
  • S.-J. Huang
    • 1
  • Margaret Altemus
    • 1
  • Dennis L. Murphy
    • 1
  1. 1.Laboratory of Clinical Science, National Institute of Mental Health, Building 10, Room 3D41, 10 Center DR MSC 1264, Bethesda, MD 20892-1264, USA e-mail: bdg@helix.nih.gov, Fax:+1-301-402-0188US

Personalised recommendations