Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Decreased Serotonin Function in Bulimia Nervosa

Decreased Serotonin Function in Bulimia Nervosa Abstract Background: Evidence that serotonin-active antidepressant medications decrease binge eating in patients with bulimia nervosa has fueled interest in the hypothesis that abnormal serotonergic neurotransmitter function contributes to symptoms of the disorder. To evaluate this hypothesis, we employed pharmacological challenge testing to compare serotonin function in patients with bulimia nervosa and healthy controls. Methods: Neuroendocrine response patterns were compared for 15 nonhospitalized, medication-free, normal-weight women with bulimia nervosa and 14 age-matched healthy female controls. Behavioral assessment included ratings of eating disorder symptoms, depression, and anxiety. Serotonergic response patterns were assessed by measuring the increase in serum prolactin concentration during 5 hours following single- dose, oral administration of 60 mg of d, l-fenfluramine hydrochloride (Pondimin). Results: For patients with bulimia nervosa, the fenfluramine-stimulated increase in serum prolactin concentration was significantly less than for controls. Within the patient group, the frequency of binge eating episodes during the 4 weeks prior to the study exhibited a significant inverse correlation with serotoninstimulated prolactin secretion. Conclusion: Our study provides new evidence that impaired central nervous system serotonergic responsiveness may contribute to the onset or maintenance of abnormal eating patterns in patients with bulimia nervosa. References 1. Kassett JA, Gershon ES, Maxwell ME, Guroff JJ, Kazuba DM, Smith AL, Brandt HA, Jimerson DC. Psychiatric disorders in the first-degree relatives of probands with bulimia nervosa . Am J Psychiatry . 1989;146:1468-1471. 2. Kendler KS, MacLean C, Neale M, Kessler R, Heath A, Eaves L. The genetic epidemiology of bulimia nervosa . Am J Psychiatry . 1991;148:1627-1637. 3. Jimerson DC, Lesem MD, Hegg AP, Brewerton TD. Serotonin in human eating disorders . Ann N Y Acad Sci . 1990;600:532-544.Crossref 4. 4Leibowitz SF, Weiss GF, Suh JS. Medial hypothalamic nuclei mediate serotonin's inhibitory effect on feeding behavior . Pharmacol Biochem Behav . 1990;37:735-742.Crossref 5. Blundell JE. Serotonin and appetite . Neuropharmacology . 1984;23:1537-1551.Crossref 6. Kitchener SJ, Dourish CT. An examination of the behavioural specificity of hypophagia induced by 5-HT1b, 5-HT1c and 5-HT2 receptor agonists using the postprandial satiety sequence in rats . Psychopharmacology . 1994;113:369-377.Crossref 7. Aulakh CS, Mazzola-Pomietto P, Wozniak KM, Hill JL, Murphy DL. Evidence that 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane-induced hypophagia and hyperthermia in rats is mediated by serotonin-2A receptors . J Pharmacol Exp Ther . 1994;270:127-132. 8. Brewerton TD, Murphy DL, Jimerson DC. Testmeal responses following m-chlorophenylpiperazine and l-tryptophan in bulimics and controls . Neuropsychopharmacology . 1994;11:63-74.Crossref 9. Chiodo J, Latimer PR. Hunger perceptions and satiety responses among normalweight bulimics and normals to a high-calorie, carbohydrate-rich food . Psychol Med . 1986;16:343-349.Crossref 10. LaChaussee JL, Kissileff HR, Walsh BT, Hadigan CM. The single-item meal as a measure of binge-eating behavior in patients with bulimia nervosa . Physiol Behav . 1992;51:593-600.Crossref 11. Chaput Y, Demontigny C, Blier P. Presynaptic and postsynaptic modifications of the serotonin system by long-term administration of antidepressant treatments: an in vivo electrophysiologic study in the rat . Neuropsychopharmacology . 1991;5:219-229. 12. Fluoxetine Bulimia Nervosa Collaborative Study Group. Fluoxetine in the treatment of bulimia nervosa: a multicenter, placebo-controlled, double-blind trial . Arch Gen Psychiatry . 1992;49:139-147.Crossref 13. Jimerson DC, Herzog DB, Brotman AW. Pharmacological approaches in the treatment of eating disorders . Harvard Rev Psychiatry . 1993;1:82-93.Crossref 14. Brewerton TD, Mueller EA, Lesem MD, Brandt HA, Quearry B, George DT, Murphy DL, Jimerson DC. Neuroendocrine responses to m-chlorophenylpiperazine and l=tryptophan in bulimia . Arch Gen Psychiatry . 1992;49:852-861.Crossref 15. Price LH, Charney DS, Delgado PL, Heninger GR. Serotonin function and depression: neuroendocrine and mood responses to intravenous l-tryptophan in depressed patients and healthy comparison subjects . Am J Psychiatry . 1991;148:1518-1525. 16. O'Keane V, O'Hanlon M, Webb M, Dinan T. d-fenfluramine prolactin response throughout the menstrual cycle: evidence for an oestrogen-induced alteration . Clin Endocrinol (Oxf) . 1991;34:289-292.Crossref 17. Dannies PS. Control of prolactin production by estrogen . In: Litwack G, ed. Biochemical Actions of Hormones . Orlando, Fla: Academic Press Inc; 1985: 289-307. 18. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington DC: American Psychiatric Press; 1987. 19. Endicott J, Spitzer RL. A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia . Arch Gen Psychiatry . 1978;35:837-844.Crossref 20. Society of Actuaries, Association of Life Insurance Medical Directors of America . Build Study, 1979 . Chicago, Ill: Society of Actuaries; 1980. 21. Gilmore JH, Ruegg RG, Ekstrom RD, Knight B, Carson SW, Mason GA, Golden RN. Altered prolactin response to clomipramine rechallenge in healthy subjects . Biol Psychiatry . 1993;34:885-888.Crossref 22. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 23. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The Eating Attitudes Test: psychometric features and clinical correlates . Psychol Med . 1982;12:871-878.Crossref 24. Spielberger CD. Manual for the State-Trait Anxiety Inventory (STAI-Form-Y) . Palo Alto, Calif: Consulting Psychologist Press; 1983. 25. Krebs HA, Cheng LK, Wright GJ. Determination of fenfluramine and norfenfluramine in plasma using a nitrogen-sensitive detector . J Chromatogr . 1984;310:412-417.Crossref 26. Denckla WD, Dewey HK. The determination of tryptophan in plasma, liver, and urine . J Lab Clin Med . 1967;69:160-169. 27. Salzman C, Jimerson D, Vasile R, Watsky E, Gerber J. Response to SSRI antidepressants correlates with reduction in plasma HVA: pilot study . Biol Psychiatry . 1993;34:569-571.Crossref 28. Norusis MJ. SPSS for Windows: Base System User's Guide, Release 6.0. Chicago, Ill: SPSS Inc; 1993. 29. Jimerson DC, Lesem MD, Kaye WH, Brewerton TD. Low serotonin and dopamine metabolite concentrations in cerebrospinal fluid from bulimic patients with frequent binge episodes . Arch Gen Psychiatry . 1992;49:132-138.Crossref 30. Goldbloom D, Garfinkel P, Katz R, Brown G. The hormonal response to intravenous 5-hydroxytryptophan in bulimia nervosa . Psychosom Med . 1990;52:225-226. Abstract. 31. McBride PA, Anderson GM, Khait VD, Sunday SR, Halmi KA. Serotonergic responsivity in eating disorders . Psychopharmacol Bull . 1991;27:365-372. 32. Levitan RD, Kaplan AS, Levitt AJ, Joffe RT. Hormonal and subjective responses to intravenous m-chlorophenylpiperazine (m-CPP) in bulimia nervosa and normal controls . Proc Int Conference Eating Disord . 1994;6:104. Abstract. 33. Siever LJ, Murphy DL, Slater S, de la Vega E, Lipper S. Plasma prolactin changes following fenfluramine in depressed patients compared to controls: an evaluation of central serotonergic responsivity in depression . Life Sci . 1984;34:1029-1039.Crossref 34. O'Keane V, Dinan TG. Prolactin and cortisol responses to d-fenfluramine in major depression: evidence for diminished responsivity of central serotonergic function . Am J Psychiatry . 1991;148:1009-1015. 35. Coccaro EF, Siever LJ, Owen K, Davis KL. Serotonin in mood and personality disorders . In: Coccaro EF, Murphy DL, eds. Serotonin In Major Psychiatric Disorders . Washington DC: American Psychiatric Press; 1990:69-97. 36. McBride PA, Anderson GM, Hertzig ME, Sweeney JA, Kream J, Cohen DJ, Mann JJ. Serotonergic responsivity in male young adults with autistic disorder: results of a pilot study . Arch Gen Psychiatry . 1989;46:213-221.Crossref 37. Miller HL, Delgado PL, Salomon RM, Berman R, Krystal JH, Heninger GR, Charney DS. Clinical and biochemical effects of catecholamine depletion on antidepressant-induced remission of depression . Arch Gen Psychiatry . 1996;53:117-128.Crossref 38. Wolfe BE, Jimerson DC, Metzger ED, Levine JM. Serotonergic challenge responses in- women with a history of bulimia nervosa . Biol Psychiatry . 1994;35:736-737. Abstract.Crossref 39. Delgado PL, Charney DS, Price LH, Landis H, Heninger GR. Neuroendocrine and behavioral effects of dietary tryptophan restriction in- healthy subjects . Life Sci . 1989;45:2323-2332.Crossref 40. Anderson IM, Parry-Billings M, Newsholme EA, Fairburn CG, Cowen PJ. Dieting reduces plasma tryptophan and alters brain 5-HT function in women . Psychol Med . 1990;20:785-791.Crossref 41. Walsh AES, Oldman AD, Franklin M, Fairburn CG, Cowen PJ. Dieting decreases plasma tryptophan and increases the prolactin response to d-fenfluramine in women but not men . J Affect Disord . 1995;33:89-97.Crossref 42. Serog P, Apfelbaum M, Autissier N, Baights F, Brigant L, Ktorza A. Effects of slimming and composition of diets on VO̊2 and thyroid hormones in healthy subjects . Am J Clin Nutr . 1982;35:24-35. 43. Pirke KM, Pahl J, Schweiger U, Warnhoff M. Metabolic and endocrine indices of starvation in bulimia: a comparison with anorexia nervosa . Psychiatry Res . 1985;15:33-39.Crossref 44. Obarzanek E, Lesem MD, Goldstein DS, Jimerson DC. Reduced resting metabolic rate in patients with bulimia nervosa . Arch Gen Psychiatry . 1991;48:456-462.Crossref 45. Levy AB, Dixon KN, Malarkey WB. Pituitary response to TRH in bulimia . Biol Psychiatry . 1988;23:476-484.Crossref 46. Weltzin TE, McConaha C, McKee M, Hsu LKG, Perel J, Kaye WH. Circadian patterns of cortisol, prolactin, and growth hormone secretion during binging and vomiting in normal weight bulimic patients . Biol Psychiatry . 1991;30:37-48.Crossref 47. Kaplan AS, Garfinkel PE, Brown GM. The DST and TRH test in bulimia nervosa . Br J Psychiatry . 1989;154:86-92.Crossref 48. Ben-Jonathan N. Regulation of prolactin secretion . In: Imura H, ed. The Pituitary Gland . 2nd ed. New York, NY: Raven Press; 1994:261-283. 49. Garattini S, Mennini T, Bendotti C, Invernizzi R, Samanin R. Neurochemical mechanism of action of drugs which modify feeding via the serotoninergic system . Appetite . 1986;7( (suppl) ):15-38.Crossref 50. Murphy DL. Peripheral indices of central serotonin function in humans . Ann N Y Acad Sci . 1990;600:282-295.Crossref 51. Van de Kar LD. Neuroendocrine pharmacology of serotonergic (5-HT) neurons . Annu Rev Pharmacol Toxicol . 1991;31:289-320.Crossref 52. Mann JJ, McBride PA, Brown RP, Linnoila M, Leon AC, DeMeo M, Mieczkowski T, Myers JE, Stanley M. Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients . Arch Gen Psychiatry . 1992;49:442-446.Crossref 53. Cowen PJ. Serotonin receptor subtypes in depression: evidence from studies in neuroendocrine regulation . Clin Neuropharmacol . 1993;16( (suppl 3) ):S6-S18. 54. Invernizzi R, Bertorelli R, Consolo S, Garattini S, Samanin R. Effects of the lisomer of fenfluramine on dopamine mechanisms in the rat brain: further studies . Eur J Pharmacol . 1989;164:241-248.Crossref 55. Coccaro EF, Kavoussi RJ, Hauger R. PRL and HVA responses to d- and d, I-fenfluramine in humans . Biol Psychiatry . 1994;35:644. Abstract.Crossref 56. Brewerton TD, Brandt HA, Lesem MD, Murphy DL, Jimerson DC. Serotonin in eating disorders . In: Coccaro EF, Murphy DL, eds. Serotonin in Major Psychiatric Disorders . Washington DC: American Psychiatric Press; 1990:153-184. 57. Hadigan CM, Walsh BT, Buttinger C, Hollander E. Behavioral and neuroendocrine responses to metaCPP in anorexia nervosa . Biol Psychiatry . 1995;37:504-511.Crossref 58. Schweiger U, Pirke KM, Laessle RG, Fichter MM. Gonadotropin secretion in bulimia nervosa . J Clin Endocrinol Metab . 1992;74:1122-1127. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Decreased Serotonin Function in Bulimia Nervosa

Download PDF
6 pages

Loading next page...
 
/lp/american-medical-association/decreased-serotonin-function-in-bulimia-nervosa-KnnKgO86co

References (60)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1997.01830180043005
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Evidence that serotonin-active antidepressant medications decrease binge eating in patients with bulimia nervosa has fueled interest in the hypothesis that abnormal serotonergic neurotransmitter function contributes to symptoms of the disorder. To evaluate this hypothesis, we employed pharmacological challenge testing to compare serotonin function in patients with bulimia nervosa and healthy controls. Methods: Neuroendocrine response patterns were compared for 15 nonhospitalized, medication-free, normal-weight women with bulimia nervosa and 14 age-matched healthy female controls. Behavioral assessment included ratings of eating disorder symptoms, depression, and anxiety. Serotonergic response patterns were assessed by measuring the increase in serum prolactin concentration during 5 hours following single- dose, oral administration of 60 mg of d, l-fenfluramine hydrochloride (Pondimin). Results: For patients with bulimia nervosa, the fenfluramine-stimulated increase in serum prolactin concentration was significantly less than for controls. Within the patient group, the frequency of binge eating episodes during the 4 weeks prior to the study exhibited a significant inverse correlation with serotoninstimulated prolactin secretion. Conclusion: Our study provides new evidence that impaired central nervous system serotonergic responsiveness may contribute to the onset or maintenance of abnormal eating patterns in patients with bulimia nervosa. References 1. Kassett JA, Gershon ES, Maxwell ME, Guroff JJ, Kazuba DM, Smith AL, Brandt HA, Jimerson DC. Psychiatric disorders in the first-degree relatives of probands with bulimia nervosa . Am J Psychiatry . 1989;146:1468-1471. 2. Kendler KS, MacLean C, Neale M, Kessler R, Heath A, Eaves L. The genetic epidemiology of bulimia nervosa . Am J Psychiatry . 1991;148:1627-1637. 3. Jimerson DC, Lesem MD, Hegg AP, Brewerton TD. Serotonin in human eating disorders . Ann N Y Acad Sci . 1990;600:532-544.Crossref 4. 4Leibowitz SF, Weiss GF, Suh JS. Medial hypothalamic nuclei mediate serotonin's inhibitory effect on feeding behavior . Pharmacol Biochem Behav . 1990;37:735-742.Crossref 5. Blundell JE. Serotonin and appetite . Neuropharmacology . 1984;23:1537-1551.Crossref 6. Kitchener SJ, Dourish CT. An examination of the behavioural specificity of hypophagia induced by 5-HT1b, 5-HT1c and 5-HT2 receptor agonists using the postprandial satiety sequence in rats . Psychopharmacology . 1994;113:369-377.Crossref 7. Aulakh CS, Mazzola-Pomietto P, Wozniak KM, Hill JL, Murphy DL. Evidence that 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane-induced hypophagia and hyperthermia in rats is mediated by serotonin-2A receptors . J Pharmacol Exp Ther . 1994;270:127-132. 8. Brewerton TD, Murphy DL, Jimerson DC. Testmeal responses following m-chlorophenylpiperazine and l-tryptophan in bulimics and controls . Neuropsychopharmacology . 1994;11:63-74.Crossref 9. Chiodo J, Latimer PR. Hunger perceptions and satiety responses among normalweight bulimics and normals to a high-calorie, carbohydrate-rich food . Psychol Med . 1986;16:343-349.Crossref 10. LaChaussee JL, Kissileff HR, Walsh BT, Hadigan CM. The single-item meal as a measure of binge-eating behavior in patients with bulimia nervosa . Physiol Behav . 1992;51:593-600.Crossref 11. Chaput Y, Demontigny C, Blier P. Presynaptic and postsynaptic modifications of the serotonin system by long-term administration of antidepressant treatments: an in vivo electrophysiologic study in the rat . Neuropsychopharmacology . 1991;5:219-229. 12. Fluoxetine Bulimia Nervosa Collaborative Study Group. Fluoxetine in the treatment of bulimia nervosa: a multicenter, placebo-controlled, double-blind trial . Arch Gen Psychiatry . 1992;49:139-147.Crossref 13. Jimerson DC, Herzog DB, Brotman AW. Pharmacological approaches in the treatment of eating disorders . Harvard Rev Psychiatry . 1993;1:82-93.Crossref 14. Brewerton TD, Mueller EA, Lesem MD, Brandt HA, Quearry B, George DT, Murphy DL, Jimerson DC. Neuroendocrine responses to m-chlorophenylpiperazine and l=tryptophan in bulimia . Arch Gen Psychiatry . 1992;49:852-861.Crossref 15. Price LH, Charney DS, Delgado PL, Heninger GR. Serotonin function and depression: neuroendocrine and mood responses to intravenous l-tryptophan in depressed patients and healthy comparison subjects . Am J Psychiatry . 1991;148:1518-1525. 16. O'Keane V, O'Hanlon M, Webb M, Dinan T. d-fenfluramine prolactin response throughout the menstrual cycle: evidence for an oestrogen-induced alteration . Clin Endocrinol (Oxf) . 1991;34:289-292.Crossref 17. Dannies PS. Control of prolactin production by estrogen . In: Litwack G, ed. Biochemical Actions of Hormones . Orlando, Fla: Academic Press Inc; 1985: 289-307. 18. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington DC: American Psychiatric Press; 1987. 19. Endicott J, Spitzer RL. A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia . Arch Gen Psychiatry . 1978;35:837-844.Crossref 20. Society of Actuaries, Association of Life Insurance Medical Directors of America . Build Study, 1979 . Chicago, Ill: Society of Actuaries; 1980. 21. Gilmore JH, Ruegg RG, Ekstrom RD, Knight B, Carson SW, Mason GA, Golden RN. Altered prolactin response to clomipramine rechallenge in healthy subjects . Biol Psychiatry . 1993;34:885-888.Crossref 22. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 23. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The Eating Attitudes Test: psychometric features and clinical correlates . Psychol Med . 1982;12:871-878.Crossref 24. Spielberger CD. Manual for the State-Trait Anxiety Inventory (STAI-Form-Y) . Palo Alto, Calif: Consulting Psychologist Press; 1983. 25. Krebs HA, Cheng LK, Wright GJ. Determination of fenfluramine and norfenfluramine in plasma using a nitrogen-sensitive detector . J Chromatogr . 1984;310:412-417.Crossref 26. Denckla WD, Dewey HK. The determination of tryptophan in plasma, liver, and urine . J Lab Clin Med . 1967;69:160-169. 27. Salzman C, Jimerson D, Vasile R, Watsky E, Gerber J. Response to SSRI antidepressants correlates with reduction in plasma HVA: pilot study . Biol Psychiatry . 1993;34:569-571.Crossref 28. Norusis MJ. SPSS for Windows: Base System User's Guide, Release 6.0. Chicago, Ill: SPSS Inc; 1993. 29. Jimerson DC, Lesem MD, Kaye WH, Brewerton TD. Low serotonin and dopamine metabolite concentrations in cerebrospinal fluid from bulimic patients with frequent binge episodes . Arch Gen Psychiatry . 1992;49:132-138.Crossref 30. Goldbloom D, Garfinkel P, Katz R, Brown G. The hormonal response to intravenous 5-hydroxytryptophan in bulimia nervosa . Psychosom Med . 1990;52:225-226. Abstract. 31. McBride PA, Anderson GM, Khait VD, Sunday SR, Halmi KA. Serotonergic responsivity in eating disorders . Psychopharmacol Bull . 1991;27:365-372. 32. Levitan RD, Kaplan AS, Levitt AJ, Joffe RT. Hormonal and subjective responses to intravenous m-chlorophenylpiperazine (m-CPP) in bulimia nervosa and normal controls . Proc Int Conference Eating Disord . 1994;6:104. Abstract. 33. Siever LJ, Murphy DL, Slater S, de la Vega E, Lipper S. Plasma prolactin changes following fenfluramine in depressed patients compared to controls: an evaluation of central serotonergic responsivity in depression . Life Sci . 1984;34:1029-1039.Crossref 34. O'Keane V, Dinan TG. Prolactin and cortisol responses to d-fenfluramine in major depression: evidence for diminished responsivity of central serotonergic function . Am J Psychiatry . 1991;148:1009-1015. 35. Coccaro EF, Siever LJ, Owen K, Davis KL. Serotonin in mood and personality disorders . In: Coccaro EF, Murphy DL, eds. Serotonin In Major Psychiatric Disorders . Washington DC: American Psychiatric Press; 1990:69-97. 36. McBride PA, Anderson GM, Hertzig ME, Sweeney JA, Kream J, Cohen DJ, Mann JJ. Serotonergic responsivity in male young adults with autistic disorder: results of a pilot study . Arch Gen Psychiatry . 1989;46:213-221.Crossref 37. Miller HL, Delgado PL, Salomon RM, Berman R, Krystal JH, Heninger GR, Charney DS. Clinical and biochemical effects of catecholamine depletion on antidepressant-induced remission of depression . Arch Gen Psychiatry . 1996;53:117-128.Crossref 38. Wolfe BE, Jimerson DC, Metzger ED, Levine JM. Serotonergic challenge responses in- women with a history of bulimia nervosa . Biol Psychiatry . 1994;35:736-737. Abstract.Crossref 39. Delgado PL, Charney DS, Price LH, Landis H, Heninger GR. Neuroendocrine and behavioral effects of dietary tryptophan restriction in- healthy subjects . Life Sci . 1989;45:2323-2332.Crossref 40. Anderson IM, Parry-Billings M, Newsholme EA, Fairburn CG, Cowen PJ. Dieting reduces plasma tryptophan and alters brain 5-HT function in women . Psychol Med . 1990;20:785-791.Crossref 41. Walsh AES, Oldman AD, Franklin M, Fairburn CG, Cowen PJ. Dieting decreases plasma tryptophan and increases the prolactin response to d-fenfluramine in women but not men . J Affect Disord . 1995;33:89-97.Crossref 42. Serog P, Apfelbaum M, Autissier N, Baights F, Brigant L, Ktorza A. Effects of slimming and composition of diets on VO̊2 and thyroid hormones in healthy subjects . Am J Clin Nutr . 1982;35:24-35. 43. Pirke KM, Pahl J, Schweiger U, Warnhoff M. Metabolic and endocrine indices of starvation in bulimia: a comparison with anorexia nervosa . Psychiatry Res . 1985;15:33-39.Crossref 44. Obarzanek E, Lesem MD, Goldstein DS, Jimerson DC. Reduced resting metabolic rate in patients with bulimia nervosa . Arch Gen Psychiatry . 1991;48:456-462.Crossref 45. Levy AB, Dixon KN, Malarkey WB. Pituitary response to TRH in bulimia . Biol Psychiatry . 1988;23:476-484.Crossref 46. Weltzin TE, McConaha C, McKee M, Hsu LKG, Perel J, Kaye WH. Circadian patterns of cortisol, prolactin, and growth hormone secretion during binging and vomiting in normal weight bulimic patients . Biol Psychiatry . 1991;30:37-48.Crossref 47. Kaplan AS, Garfinkel PE, Brown GM. The DST and TRH test in bulimia nervosa . Br J Psychiatry . 1989;154:86-92.Crossref 48. Ben-Jonathan N. Regulation of prolactin secretion . In: Imura H, ed. The Pituitary Gland . 2nd ed. New York, NY: Raven Press; 1994:261-283. 49. Garattini S, Mennini T, Bendotti C, Invernizzi R, Samanin R. Neurochemical mechanism of action of drugs which modify feeding via the serotoninergic system . Appetite . 1986;7( (suppl) ):15-38.Crossref 50. Murphy DL. Peripheral indices of central serotonin function in humans . Ann N Y Acad Sci . 1990;600:282-295.Crossref 51. Van de Kar LD. Neuroendocrine pharmacology of serotonergic (5-HT) neurons . Annu Rev Pharmacol Toxicol . 1991;31:289-320.Crossref 52. Mann JJ, McBride PA, Brown RP, Linnoila M, Leon AC, DeMeo M, Mieczkowski T, Myers JE, Stanley M. Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients . Arch Gen Psychiatry . 1992;49:442-446.Crossref 53. Cowen PJ. Serotonin receptor subtypes in depression: evidence from studies in neuroendocrine regulation . Clin Neuropharmacol . 1993;16( (suppl 3) ):S6-S18. 54. Invernizzi R, Bertorelli R, Consolo S, Garattini S, Samanin R. Effects of the lisomer of fenfluramine on dopamine mechanisms in the rat brain: further studies . Eur J Pharmacol . 1989;164:241-248.Crossref 55. Coccaro EF, Kavoussi RJ, Hauger R. PRL and HVA responses to d- and d, I-fenfluramine in humans . Biol Psychiatry . 1994;35:644. Abstract.Crossref 56. Brewerton TD, Brandt HA, Lesem MD, Murphy DL, Jimerson DC. Serotonin in eating disorders . In: Coccaro EF, Murphy DL, eds. Serotonin in Major Psychiatric Disorders . Washington DC: American Psychiatric Press; 1990:153-184. 57. Hadigan CM, Walsh BT, Buttinger C, Hollander E. Behavioral and neuroendocrine responses to metaCPP in anorexia nervosa . Biol Psychiatry . 1995;37:504-511.Crossref 58. Schweiger U, Pirke KM, Laessle RG, Fichter MM. Gonadotropin secretion in bulimia nervosa . J Clin Endocrinol Metab . 1992;74:1122-1127.

Journal

Archives of General Psychiatry – American Medical Association

Published: Jun 1, 1997

There are no references for this article.