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Serotonergic Function in Obsessive-Compulsive Disorder Behavioral and Neuroendocrine Responses to Oral m-Chlorophenylpiperazine and Fenfluramine in Patients and Healthy Volunteers

Eric Hollander, MD; Concetta M. DeCaria, MS; Anca Nitescu, MA; Robert Gully; Raymond F. Suckow, PhD; Thomas B. Cooper, MA; Jack M. Gorman, MD; Donald F. Klein, MD; Michael R. Liebowitz, MD
Arch Gen Psychiatry. 1992;49(1):21-28. doi:10.1001/archpsyc.1992.01820010021003.
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• To evaluate serotonergic (5-hydroxytryptamine) function in obsessive-compulsive disorder, behavioral and neuroendocrine responses to m-chlorophenylpiperazine (m-CPP; 0.5 mg/kg orally) and fenfluramine hydrochloride (60 mg orally) were examined in 20 patients and 10 healthy controls under double-blind, placebo-controlled conditions. Following m-CPP, but not fenfluramine or placebo, 55% (11/20) of the patients with obsessive-compulsive disorder experienced a transient exacerbation of obsessivecompulsive disorder. Prolactin response was blunted in patients following m-CPP but not following fenfluramine. Patients with greater behavioral response to m-CPP had smaller prolactin responses. Cortisol response to m-CPP and fenfluramine did not significantly differ between the groups. Behavioral and neuroendocrine responses appeared divergent. This does not suggest simply upregulation or downregulation of 5-hydroxytryptamine receptors, but rather complex mechanisms involving multiple neurotransmitter and neuromodulator systems.


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