Usefulness of serotoninergic challenge with oral citalopram

Abstract

Usefulness of serotoninergic challenge with oral citalopram Utilidade do desafio serotoninérgico com citalopram oral A b s t r a c t Objective: Challenge tests designed to evaluate serotoninergic pathways have widely used intravenous citalopram. Oral citalopram has also been used, but unsatisfactory results were obtained with a dose of 20 mg. The objective of this study was to determine whether a higher oral dose would reproduce similar to those described for intravenous administration. To that end, we evaluated cortisol, growth hormone and prolactin levels. Method: Eight healthy male volunteers were evaluated in a randomized crossover challenge test with 40 mg of oral citalopram or placebo. Results: Cortisol levels increased at 2-4h after the oral citalopram intake, with a small amplitude peak occurring in two-thirds of the subjects. Levels of prolactin and growth hormone remained unchanged throughout the study. Conclusion: The use of oral citalopram might present an alternative in serotoninergic challenge tests, but higher doses are required.

Discriminating Depression, Physical and Social Anhedonia by Neurotransmitter Related Challenge Tests

“…review by Power & Cowen, 1992;Yatham & Steiner, 1993 for the serotonergic systems or review by Coupland et al, 1992 for the noradrenergic system, and by Insel & Sievers, 1981 for the dopaminergic system). Depressed patients, for instance, have been reported to show blunted hormone responses to the 5-hydroxy-tryptamine (5-HT) releaser d-fenfluramine (Cleare et al, 1996), the 5-HT-reuptake inhibitors citalopram (Mattos et al, 2006), or clomipramin (Anderson et al, 1992), as well as increased hormone responses to stimulation of the noradrenertgic system (NA), e.g., by the alpha2 receptor agonist clonidine (Charney et al, 1982;Lesch et al, 1988) or the noradrenaline reuptake inhibitor reboxetine (Schüle et al, 2004). Depressed patients also have been shown to exhibit low dopaminergic activity (Boadie et al, 2007) indicated e.g.…”