Abnormal neuroendocrine response to clomipramine in hereditary affective psychosis

Depress Anxiety. 2009;26(8):E111-9. doi: 10.1002/da.20405.

Abstract

Background: Blunting of prolactin response after serotonergic stimulation during a major depressive episode has been described by several investigators. In this study, the neuroendocrine responses to clomipramine were assessed in remitted patients suffering from hereditary depression.

Methods: Twenty remitted patients from 11 large families with multigenerational, multiple cases of major affective disorder (bipolar disorder n=15, recurrent depression n=5, according DSM-IV) and 12 healthy relatives were investigated. After intravenous application of 12.5 mg of the serotonin re-uptake inhibitor clomipramine, serum prolactin and cortisol levels were analysed.

Results: Patients and comparison group did not differ significantly with respect to age, baseline prolactin and cortisol concentrations. A gender effect was found in an exploratory analysis for prolactin but not for cortisol and therefore the data for prolactin were analysed separately. After clomipramine infusion, the increase of cortisol was significantly lower in patients than in the comparison group (P=.046). For prolactin, this effect could be found in the male (P=.012) as well as in the female (P=.007) subsample.

Conclusions: These results suggest that blunted prolactin and cortisol responses to serotonergic stimulation are characteristic for remitted depressive patients with previous episodes of major affective disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents, Tricyclic*
  • Bipolar Disorder / blood*
  • Bipolar Disorder / genetics*
  • Clomipramine*
  • Depressive Disorder, Major / blood*
  • Depressive Disorder, Major / genetics*
  • Female
  • Genetic Predisposition to Disease / genetics
  • Genotype
  • Humans
  • Hydrocortisone / blood
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Personality Inventory
  • Prolactin / blood*
  • Reference Values
  • Selective Serotonin Reuptake Inhibitors*
  • Serotonin Plasma Membrane Transport Proteins / genetics
  • Suicide / psychology
  • Young Adult

Substances

  • Antidepressive Agents, Tricyclic
  • SLC6A4 protein, human
  • Serotonin Plasma Membrane Transport Proteins
  • Serotonin Uptake Inhibitors
  • Prolactin
  • Clomipramine
  • Hydrocortisone