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Hormonal and Subjective Responses to Intravenous meta-Chlorophenylpiperazine in Bulimia Nervosa

Robert D. Levitan, MD; Allan S. Kaplan, MD; Russell T. Joffe, MD; Anthony J. Levitt, MD; Gregory M. Brown, MD
Arch Gen Psychiatry. 1997;54(6):521-527. doi:10.1001/archpsyc.1997.01830180027004.
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Background:  Several lines of evidence point to serotonergic abnormalities in patients with bulimia nervosa (BN). Our goal was to further examine central serotonergic function in bulimic patients using neuroendocrine and subjective responses to the postsynaptic serotonin receptor agonist meta-chlorophenylpiperazine (mCPP).

Method:  Using a double-blind, randomized, placebo-controlled design, we assessed neuroendocrine and subjective responses to intravenous mCPP (0.1 mg/kg) and placebo in 16 patients with BN, free of medication, and 14 normal control subjects. Plasma prolactin and cortisol levels were used as neuroendocrine measures, whereas subjective responses were measured using a visual analog scale of 10 different mood states.

Results:  Compared with controls, the BN group exhibited blunted prolactin and net cortisol responses following mCPP challenge. Subjective responses, while preliminary, also differed between groups on items related to anxiety, calmness, and altered self-awareness.

Conclusion:  Evidence of dysfunction at or downstream of central serotonergic receptors in BN confirms and extends findings of prior research.

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