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Relationship Between Central and Peripheral Serotonin Indexes in Depressed and Suicidal Psychiatric Inpatients

Relationship Between Central and Peripheral Serotonin Indexes in Depressed and Suicidal... Abstract • Serious suicidal behavior, affective disorders, and a variety of other psychopathologic behaviors and syndromes have been found to correlate with measures of the serotonin system. Clinical studies have employed a range of serotonin indexes, including the cerebrospinal fluid level of 5-hydroxyindoleacetic acid, the prolactin response to serotonin agonists, such as fenfluramine hydrochloride, and platelet serotonin-related proteins or serotonin content. Many of these indexes are correlated with suicidal behavior, but the interrelationship of these biologic measures has been uncertain. We studied the relationship of a series of serotonin indexes in patients in whom these measures were correlated with suicidal behavior. A positive correlation was found between cerebrospinal fluid 5-hydroxyindoleacetic acid and the maximal prolactin response to fenfluramine but not with platelet serotonin, receptor indexes. The fenfluramine-stimulated maximal prolactin response correlated with platelet serotonin2 receptor number, particularly in older patients. We conclude that cerebrospinal fluid 5-hydroxyindoleacetic acid measurements cannot be replaced but can be complemented by less invasive procedures, such as a fenfluramine challenge test or platelet serotonin2 measures, in the study of the relationship of the serotonin system to psychiatric disorders. References 1. Mann JJ, Arango V, Marzuk PM, Theccanat S, Reis DJ. Evidence for the 5-HT hypothesis of suicide: a review of post-mortem studies . Br J Psychiatry Suppl . 1989;155:7-14.Crossref 2. Mann JJ, Stanley M, eds. Psychobiology of Suicidal Behavior . New York, NY: New York Academy of Sciences; 1986:1-357. 3. Mann JJ, Arango V, Underwood MD. Serotonin and suicidal behavior . In: Whitaker-Azmitia PM, Peroutka SJ, eds. The Neuropharmacology of Serotonin . New York, NY: New York Academy of Sciences; 1990:476-485. 4. Mann JJ, Marzuk PM, Arango V, McBride PA, Leon AC, Tierney H. Neurochemical studies of violent and nonviolent suicide . Psychopharmacol Bull . 1989;25:407-413. 5. Asberg M, Traskman-Bendz L, Thoren P. 5-HIAA in the cerebrospinal fluid: a biochemical suicide predictor? Arch Gen Psychiatry . 1976;33:1193-1197.Crossref 6. Coccaro EF, Siever LJ, Klar HM, Maurer G, Cochrane K, Cooper TB, Mohs RC, Davis KL. Serotonergic studies in patients with affective and personality disorders . Arch Gen Psychiatry . 1989;46:587-599.Crossref 7. McBride PA, Tierney H, DeMeo M, Chen J-S, Mann JJ. Effects of age and gender on CNS serotonergic responsivity in normal adults . Biol Psychiatry . 1990;27:1143-1155.Crossref 8. McBride PA, Anderson GM, Hertzig ME, Sweeney JA, Kream J, Cohen DJ, Mann JJ. Serotonergic responsivity in male young adults with autistic disorder . Arch Gen Psychiatry . 1989;46:213-221.Crossref 9. McBride PA, Brown RP, DeMeo M, Keilp J, Stanley M, Mann JJ, Polly M. Platelet 5-HT2 receptors: depression and suicide. Presented at the 140th Annual Meeting of the American Psychiatric Association, New Research; May 11-13, 1987; Chicago, III. Abstract NR157. 10. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 11. Beck AT, Beck R, Kovacs M. Classification of suicidal behaviors, I: quantifying intent and medical lethality source . Am J Psychiatry . 1975;132:285-287. 12. Scheinin M, Chang W-H, Kirk KL, Linnoila M. Simultaneous determination of 3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindoleacetic acid, and homovanillic acid in cerebrospinal fluid with highperformance liquid chromatography using electrochemical detection . Anal Biochem . 1983;131:246-253.Crossref 13. Garattini S, Jori A, Buczko W, Samanin R. The mechanism of action of fenfluramine . Postgrad Med J . 1975;51( (suppl 1) ):27-35. 14. Reuter CJ. A review of CNS effects of fenfluramine, 780SE and norfenfluramine on animals and man . Postgrad Med J . 1975;51( (suppl 1) ):18-27.Crossref 15. Oreland L, Wiberg A, Asberg M, Traskman L, Sjostrand L, Thoren P, Bertilsson L, Tubrina G. Platelet MAO activity and monoamine metabolites in cerebrospinal fluid in depressed and suicidal patients and in healthy controls . Psychiatry Res . 1981;4:21-29.Crossref 16. Stoff MD, Goldman W, Bridger WH, Jain AK, Pylypiw A. No correlation between platelet imipramine binding and CSF 5-HIAA in neurosurgical patients . Psychiatry Res . 1990;33:323-326.Crossref 17. Sarrias MJ, Cabre P, Martinez E, Artigas F. Relationship between serotoninergic measures in blood and cerebrospinal fluid simultaneously obtained in humans . J Neurochem . 1990;54:783-786.Crossref 18. Young WF, Laws ER, Sharbrough FW, Weinshilboum RM. Human monoamine oxidase: lack of brain and platelet correlation . Arch Gen Psychiatry . 1986;43:604-609.Crossref 19. Carlsson A, Svennerholm L, Winblad B. Seasonal and circadian monoamine variations in human brains examined post mortem . Acta Psychiatr Scand . 1980;280( (suppl) ):75-85. 20. Wirz-Justice A. Circadian rhythms in mammalian neurotransmitter receptors . Prog Neurobiol . 1987;29:219-259.Crossref 21. Nicoletti F, Raffaele A, Falsaperia A, Paci R. Circadian variation in 5-hydroxyindoleacetic acid levels in human cerebrospinal fluid . Eur Neurol . 1981;20:834-838.Crossref 22. Stanley M, Traskman-Bendz L, Dorovini-Zis K. Correlations between aminergic metabolites simultaneously obtained from human CSF and brain . Life Sci . 1985;37:1279-1286.Crossref 23. Knott P, Haroutunian V, Bierer L, Perl D, Handler M, DeLeon M, Yang R-K, David K. Correlations post-mortem between ventricular CSF and cortical tissue concentrations of MHPG, 5-HIAA and HVA in Alzheimer's disease . Biol Psychiatry . 1989;25( (suppl 7A) ):112A.Crossref 24. Brewerton TD, Brandt HA, Lessem MD, Murphy DL, Jimerson DC. Serotonin in eating disorders . In: Coccaro EF, Murphy DL, eds. Serotonin in Major Psychiatric Disorders . 21st ed. Washington, DC: American Psychiatric Press Inc; 1990:155-184. 25. DeMeo M, McBride PA, Mann JJ, Keilp J. Fenfluramine challenge in major depression. Presented at the 141st Annual Meeting of the American Psychiatric Association; May 7-13, 1988; Montreal, Quebec. Abstract NR169. 26. Cosi C, Kim HS, Wood PL. Serotonergic (5-HT2) regulation of plasma corticosterone and prolactin . Soc Neurosci Abstr . 1988;14:846. Abstract. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Relationship Between Central and Peripheral Serotonin Indexes in Depressed and Suicidal Psychiatric Inpatients

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References (29)

Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1992.01820060022003
Publisher site
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Abstract

Abstract • Serious suicidal behavior, affective disorders, and a variety of other psychopathologic behaviors and syndromes have been found to correlate with measures of the serotonin system. Clinical studies have employed a range of serotonin indexes, including the cerebrospinal fluid level of 5-hydroxyindoleacetic acid, the prolactin response to serotonin agonists, such as fenfluramine hydrochloride, and platelet serotonin-related proteins or serotonin content. Many of these indexes are correlated with suicidal behavior, but the interrelationship of these biologic measures has been uncertain. We studied the relationship of a series of serotonin indexes in patients in whom these measures were correlated with suicidal behavior. A positive correlation was found between cerebrospinal fluid 5-hydroxyindoleacetic acid and the maximal prolactin response to fenfluramine but not with platelet serotonin, receptor indexes. The fenfluramine-stimulated maximal prolactin response correlated with platelet serotonin2 receptor number, particularly in older patients. We conclude that cerebrospinal fluid 5-hydroxyindoleacetic acid measurements cannot be replaced but can be complemented by less invasive procedures, such as a fenfluramine challenge test or platelet serotonin2 measures, in the study of the relationship of the serotonin system to psychiatric disorders. References 1. Mann JJ, Arango V, Marzuk PM, Theccanat S, Reis DJ. Evidence for the 5-HT hypothesis of suicide: a review of post-mortem studies . Br J Psychiatry Suppl . 1989;155:7-14.Crossref 2. Mann JJ, Stanley M, eds. Psychobiology of Suicidal Behavior . New York, NY: New York Academy of Sciences; 1986:1-357. 3. Mann JJ, Arango V, Underwood MD. Serotonin and suicidal behavior . In: Whitaker-Azmitia PM, Peroutka SJ, eds. The Neuropharmacology of Serotonin . New York, NY: New York Academy of Sciences; 1990:476-485. 4. Mann JJ, Marzuk PM, Arango V, McBride PA, Leon AC, Tierney H. Neurochemical studies of violent and nonviolent suicide . Psychopharmacol Bull . 1989;25:407-413. 5. Asberg M, Traskman-Bendz L, Thoren P. 5-HIAA in the cerebrospinal fluid: a biochemical suicide predictor? Arch Gen Psychiatry . 1976;33:1193-1197.Crossref 6. Coccaro EF, Siever LJ, Klar HM, Maurer G, Cochrane K, Cooper TB, Mohs RC, Davis KL. Serotonergic studies in patients with affective and personality disorders . Arch Gen Psychiatry . 1989;46:587-599.Crossref 7. McBride PA, Tierney H, DeMeo M, Chen J-S, Mann JJ. Effects of age and gender on CNS serotonergic responsivity in normal adults . Biol Psychiatry . 1990;27:1143-1155.Crossref 8. McBride PA, Anderson GM, Hertzig ME, Sweeney JA, Kream J, Cohen DJ, Mann JJ. Serotonergic responsivity in male young adults with autistic disorder . Arch Gen Psychiatry . 1989;46:213-221.Crossref 9. McBride PA, Brown RP, DeMeo M, Keilp J, Stanley M, Mann JJ, Polly M. Platelet 5-HT2 receptors: depression and suicide. Presented at the 140th Annual Meeting of the American Psychiatric Association, New Research; May 11-13, 1987; Chicago, III. Abstract NR157. 10. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 11. Beck AT, Beck R, Kovacs M. Classification of suicidal behaviors, I: quantifying intent and medical lethality source . Am J Psychiatry . 1975;132:285-287. 12. Scheinin M, Chang W-H, Kirk KL, Linnoila M. Simultaneous determination of 3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindoleacetic acid, and homovanillic acid in cerebrospinal fluid with highperformance liquid chromatography using electrochemical detection . Anal Biochem . 1983;131:246-253.Crossref 13. Garattini S, Jori A, Buczko W, Samanin R. The mechanism of action of fenfluramine . Postgrad Med J . 1975;51( (suppl 1) ):27-35. 14. Reuter CJ. A review of CNS effects of fenfluramine, 780SE and norfenfluramine on animals and man . Postgrad Med J . 1975;51( (suppl 1) ):18-27.Crossref 15. Oreland L, Wiberg A, Asberg M, Traskman L, Sjostrand L, Thoren P, Bertilsson L, Tubrina G. Platelet MAO activity and monoamine metabolites in cerebrospinal fluid in depressed and suicidal patients and in healthy controls . Psychiatry Res . 1981;4:21-29.Crossref 16. Stoff MD, Goldman W, Bridger WH, Jain AK, Pylypiw A. No correlation between platelet imipramine binding and CSF 5-HIAA in neurosurgical patients . Psychiatry Res . 1990;33:323-326.Crossref 17. Sarrias MJ, Cabre P, Martinez E, Artigas F. Relationship between serotoninergic measures in blood and cerebrospinal fluid simultaneously obtained in humans . J Neurochem . 1990;54:783-786.Crossref 18. Young WF, Laws ER, Sharbrough FW, Weinshilboum RM. Human monoamine oxidase: lack of brain and platelet correlation . Arch Gen Psychiatry . 1986;43:604-609.Crossref 19. Carlsson A, Svennerholm L, Winblad B. Seasonal and circadian monoamine variations in human brains examined post mortem . Acta Psychiatr Scand . 1980;280( (suppl) ):75-85. 20. Wirz-Justice A. Circadian rhythms in mammalian neurotransmitter receptors . Prog Neurobiol . 1987;29:219-259.Crossref 21. Nicoletti F, Raffaele A, Falsaperia A, Paci R. Circadian variation in 5-hydroxyindoleacetic acid levels in human cerebrospinal fluid . Eur Neurol . 1981;20:834-838.Crossref 22. Stanley M, Traskman-Bendz L, Dorovini-Zis K. Correlations between aminergic metabolites simultaneously obtained from human CSF and brain . Life Sci . 1985;37:1279-1286.Crossref 23. Knott P, Haroutunian V, Bierer L, Perl D, Handler M, DeLeon M, Yang R-K, David K. Correlations post-mortem between ventricular CSF and cortical tissue concentrations of MHPG, 5-HIAA and HVA in Alzheimer's disease . Biol Psychiatry . 1989;25( (suppl 7A) ):112A.Crossref 24. Brewerton TD, Brandt HA, Lessem MD, Murphy DL, Jimerson DC. Serotonin in eating disorders . In: Coccaro EF, Murphy DL, eds. Serotonin in Major Psychiatric Disorders . 21st ed. Washington, DC: American Psychiatric Press Inc; 1990:155-184. 25. DeMeo M, McBride PA, Mann JJ, Keilp J. Fenfluramine challenge in major depression. Presented at the 141st Annual Meeting of the American Psychiatric Association; May 7-13, 1988; Montreal, Quebec. Abstract NR169. 26. Cosi C, Kim HS, Wood PL. Serotonergic (5-HT2) regulation of plasma corticosterone and prolactin . Soc Neurosci Abstr . 1988;14:846. Abstract.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jun 1, 1992

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