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Acute hormonal changes after IV citalopram and treatment response in OCD

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Abstract

Rationale

Serotonergic pharmacological challenges have failed to produce consensual results in patients with obsessive–compulsive disorder (OCD), suggesting a heterogeneous 5-hydroxytryptamine (5-HT) activity in this disorder.

Objectives

The aim of this study was to compare the neuroendocrine response to a serotonergic challenge in OCD patient responders (RP) and nonresponders (NR) to serotonin reuptake inhibitors treatment and healthy volunteers.

Materials and methods

Thirty OCD treatment NR, 30 RP, and 30 controls (CN) matched for sex and age were included. Each subject received 20 mg of intravenous citalopram. Prolactin, cortisol, and growth hormone plasma concentration were measured at times—20, 0, 20, 40, 60, 80, 100, 120, 140, and 160 min after the onset of citalopram infusion.

Results

Citalopram did not induce anxiety or OCD symptoms in patients. Citalopram was associated with stronger prolactin response in the CN group (maximal percentage variation [max%Δ] = 65.76 ± 105.1) than in NR (max%Δ = 17.41 ± 31.06) and RP groups (max%Δ = 15.87 ± 31.71; p = 0.032; Friedman χ 2 = 6.87; df = 2). On the other hand, cortisol response did not differ between CN and RP groups and was blunted in the NR group (NR max%Δ = 20.98 ± 58.14 vs RP max%Δ = 47.69 ± 66.94; CN max%Δ = 63.58 ± 88.4; p = 0.015; Friedman χ 2 = 8.60; df = 2).

Conclusions

Compared to CN, both treatment RP and NR patients showed blunted prolactin response to citalopram, but only NR patients showed an attenuated cortisol response, suggesting a more disrupted central serotonergic transmission in this group.

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References

  • Adams KH, Hansen ES, Pinborg LH, Hasselbalch SG, Svarer C, Holm S, Bolwig TG, Knudsen GM (2005) Patients with obsessive–compulsive disorder have increased 5-HT2A receptor binding in the caudate nuclei. Int J Neuropsychopharmacol 8(3):391–401, Sep

    Article  PubMed  CAS  Google Scholar 

  • Attenburrow MJ, Mitter PR, Whale R, Terao T, Cowen PJ (2001) Low-dose citalopram as a 5-HT neuroendocrine probe. Psychopharmacology (Berl) 155(3):323–326, May

    Article  CAS  Google Scholar 

  • Bijak M, Zahorodna A, Tokarski K (2001) Opposite effects of antidepressants and corticosterone on the sensitivity of hippocampal CA1 neurons to 5-HT1A and 5-HT4 receptor activation. Naunyn Schmiedebergs Arch Pharmacol 363(5):491–498, May

    Article  PubMed  CAS  Google Scholar 

  • Charney DS, Goodman WK, Price LH, Woods SW, Rasmussen SA, Heninger GR (1988) Serotonin function in obsessive–compulsive disorder. A comparison of the effects of tryptophan and m-chlorophenylpiperazine in patients and healthy subjects. Arch Gen Psychiatry 45(2):177–185, Feb

    PubMed  CAS  Google Scholar 

  • Dalton GL, Lee MD, Kennett GA, Dourish CT, Clifton PG (2004) mCPP-induced hyperactivity in 5-HT2C receptor mutant mice is mediated by activation of multiple 5-HT receptor subtypes. Neuropharmacology 46(5):663–671, Apr

    Article  PubMed  CAS  Google Scholar 

  • Denys D (2006) Pharmacotherapy of obsessive–compulsive disorder and obsessive–compulsive spectrum disorders. Psychiatr Clin North Am 29(2):553–584, Jun

    Article  PubMed  Google Scholar 

  • Dremencov E, Gur E, Lerer B, Newman ME (2002) Effects of chronic antidepressants and electroconvulsive shock on serotonergic neurotransmission in the rat hypothalamus. Prog Neuropsychopharmacol Biol Psychiatry 26(6):1029–1034, Oct

    Article  PubMed  CAS  Google Scholar 

  • Fineberg NA, Roberts A, Montgomery SA, Cowen PJ (1997) Brain 5-HT function in obsessive–compulsive disorder. Prolactin responses to d-fenfluramine. Br J Psychiatry 171:280–282, Sep

    PubMed  CAS  Google Scholar 

  • Flory JD, Manuck SB, Perel JM, Muldoon MF (2004) A comparison of d, l-fenfluramine and citalopram challenges in healthy adults. Psychopharmacology (Berl) 174(3):376–380, Jul

    CAS  Google Scholar 

  • Graeff FG (2004) Serotonin, the periaqueductal gray and panic. Neurosci Biobehav Rev 28(3):239–259, May

    Article  PubMed  CAS  Google Scholar 

  • Gross-Isseroff R, Cohen R, Sasson Y, Voet H, Zohar J (2004) Serotonergic dissection of obsessive compulsive symptoms: a challenge study with m-chlorophenylpiperazine and sumatriptan. Neuropsychobiology 50(3):200–205

    Article  PubMed  CAS  Google Scholar 

  • Gur E, Dremencov E, Lerer B, Newman ME (2001) Functional effects of corticosterone on 5-HT(1A) and 5-HT(1B) receptor activity in rat brain: in vivo microdialysis studies. Eur J Pharmacol 411(1–2):115–122, Jan 5

    Article  PubMed  CAS  Google Scholar 

  • Hawken ER, Owen JA, Van Vugt D, Delva NJ (2006) Effects of oral racemic citalopram on neuroendocrine responses. Prog Neuropsychopharmacol Biol Psychiatry 30(4):694–700, Jun

    Article  PubMed  CAS  Google Scholar 

  • Henning J, Netter P (2002) Oral application of citalopram (20 mg) and its usefulness for neuroendocrine challenge tests. Int J Neuropsychopharmacol 5(1):67–71, Mar

    Article  PubMed  CAS  Google Scholar 

  • Hollander E, Fay M, Cohen B, Campeas R, Gorman JM, Liebowitz MR (1988) Serotonergic and noradrenergic sensitivity in obsessive–compulsive disorder: behavioral findings. Am J Psychiatry 145(8):1015–1017, Aug

    PubMed  CAS  Google Scholar 

  • Hollander E, DeCaria CM, Nitescu A, Gully R, Suckow RF, Cooper TB, Gorman JM, Klein DF, Liebowitz MR (1992) Serotonergic function in obsessive–compulsive disorder. Behavioral and neuroendocrine responses to oral m-chlorophenylpiperazine and fenfluramine in patients and healthy volunteers. Arch Gen Psychiatry 49(1):21–28, Jan

    PubMed  CAS  Google Scholar 

  • Kapitany T, Schindl M, Schindler SD, Hesselmann B, Fureder T, Barnas C, Sieghart W, Kasper S (1999) The citalopram challenge test in patients with major depression and in healthy controls. Psychiatry Res 88(2):75–88, Nov 8

    Article  PubMed  CAS  Google Scholar 

  • Karten YJ, Nair SM, van Essen L, Sibug R, Joels M (1999) Long-term exposure to high corticosterone levels attenuates serotonin responses in rat hippocampal CA1 neurons. Proc Natl Acad Sci U S A 96(23):13456–13461, Nov 9

    Article  PubMed  CAS  Google Scholar 

  • Khanna S, John JP, Reddy LP (2001) Neuroendocrine and behavioral responses to mCPP in obsessive–compulsive disorder. Psychoneuroendocrinology 26(2):209–223

    Article  PubMed  CAS  Google Scholar 

  • Lesch KP, Hoh A, Schulte HM, Osterheider M, Muller T (1991) Long-term fluoxetine treatment decreases 5-HT1A receptor responsivity in obsessive–compulsive disorder. Psychopharmacology (Berl) 105(3):415–420

    Article  CAS  Google Scholar 

  • Lowe SL, Yeo KP, Teng L, Soon DK, Pan A, Wise SD, Peck RW (2006) l-5-Hydroxytryptophan augments the neuroendocrine response to a SSRI. Psychoneuroendocrinology 31(4):473–484

    Article  PubMed  CAS  Google Scholar 

  • Lucey JV, O’Keane V, Butcher G, Clare AW, Dinan TG (1992) Cortisol and prolactin responses to d-fenfluramine in non-depressed patients with obsessive–compulsive disorder: a comparison with depressed and healthy controls. Br J Psychiatry 161:517–521

    Article  PubMed  CAS  Google Scholar 

  • Monteleone P, Catapano F, Di Martino S, Ferraro C, Maj M (1997) Prolactin response to d-fenfluramine in obsessive–compulsive patients, and outcome of fluvoxamine treatment. Br J Psychiatry 170:554–557

    PubMed  CAS  Google Scholar 

  • Pariante CM, Papadopoulos AS, Poon L, Cleare AJ, Checkley SA, English J, Kerwin RW, Lightman S (2004) Four days of citalopram increase suppression of cortisol secretion by prednisolone in healthy volunteers. Psychopharmacology (Berl) 177(1–2):200–206

    Article  CAS  Google Scholar 

  • Pinborg LH, Adams KH, Yndgaard S, Hasselbalch SG, Holm S, Kristiansen H, Paulson OB, Knudsen GM (2004) [18F]altanserin binding to human 5HT2A receptors is unaltered after citalopram and pindolol challenge. J Cereb Blood Flow Metab 24(9):1037–1045

    Article  PubMed  CAS  Google Scholar 

  • Raap DK, Van de Kar (1999) Selective serotonin reuptake inhibitors and neuroendocrine function. Life Sci 65(12):1217–1235

    Article  PubMed  CAS  Google Scholar 

  • Shlik J, Maron E, Tru I, Aluoja A, Vasar V (2004) Citalopram challenge in social anxiety disorder. Int J Neuropsychopharmacol 7(2):177–182

    Article  PubMed  CAS  Google Scholar 

  • Zohar J, Mueller EA, Insel TR, Zohar-Kadouch RC, Murphy DL (1987) Serotonergic responsivity in obsessive–compulsive disorder. Comparison of patients and healthy controls. Arch Gen Psychiatry 44(11):946–951

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo grant number 99/00170-4. This study complies with current Brazilian laws.

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Authors and Affiliations

  1. Ambulatório de Ansiedade, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, R. Ovídio Pires de Campos, n°785, São Paulo, SP, Brasil

    Fábio M. Corregiari & Márcio Bernik

  2. Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, R. Ovídio Pires de Campos, n°785, São Paulo, SP, Brasil

    Fábio M. Corregiari, Wagner F. Gattaz & Márcio Bernik

  3. Laboratório de Neurociências (LIM-27), Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, R. Ovídio Pires de Campos, n°785, São Paulo, SP, Brasil

    Wagner F. Gattaz

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  1. Fábio M. Corregiari
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  2. Wagner F. Gattaz
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  3. Márcio Bernik
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Correspondence to Márcio Bernik.

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Corregiari, F.M., Gattaz, W.F. & Bernik, M. Acute hormonal changes after IV citalopram and treatment response in OCD. Psychopharmacology 193, 487–494 (2007). https://doi.org/10.1007/s00213-007-0793-0

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  • DOI: https://doi.org/10.1007/s00213-007-0793-0

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