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Effect of Clozapine on d-Fenfluramine-Evoked Neuroendocrine Responses in Schizophrenia and its Relationship to Clinical Improvement

Published online by Cambridge University Press:  02 January 2018

Vivienne A. Curtis ,
Pádraig Wright ,
Adrianne Reveley ,
Robert Kerwin  and
James V. Lucey
Vivienne A. Curtis*
Affiliation:
Institute of Psychiatry, London
Pádraig Wright
Affiliation:
Institute of Psychiatry, London
Adrianne Reveley
Affiliation:
Institute of Psychiatry, London
Robert Kerwin
Affiliation:
Institute of Psychiatry, London
James V. Lucey
Affiliation:
Institute of Psychiatry, London
*
Dr Curtis, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
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Abstract

Background

Clozapine is an effective antipsychotic that has high affinity for serotonin type 2 (5-HT2) receptors. The importance of 5-HT antagonism in the overall clinical efficacy of clozapine is unclear. Using a neuroendocrine strategy we tested the hypothesis that clinical response to clozapine is related to alteration in 5-HT function.

Method

Ten treatment-resistant schizophrenic subjects were treated with clozapine for a mean of 10.3 (s.e. 0.9) weeks; d-fenfluramine (DFEN) challenge tests were performed before and after treatment with concurrent clinical ratings (BPRS, SAPS, SANS) made at the time of testing.

Results

All patients showed clinical improvement following treatment with clozapine. In addition, clozapine produced a significant attenuation of prolactin (PRL) and cortisol (CRT) response to DFEN challenge. Change in symptom ratings correlated significantly with reduction in PRL response to DFEN challenge.

Conclusions

These data show that functional alterations occur in the 5-HT system following response to clozapine and lend support to studies suggesting that 5-HT is an important component to the spectrum of action of clozapine.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 5 , May 1995 , pp. 642 - 646
Copyright
Copyright © Royal College of Psychiatrists, 1995 

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