Baseline prolactin and L-tryptophan availability predict response to antidepressant treatment in major depression

Porter, Richard; Mulder, Roger; Joyce, Peter R.

doi:10.1007/s00213-002-1282-0

Cited by 20 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This fi nding is consistent with a previous report showing that high BPV might predict response to nonselective tricyclic antidepressants in depressed patients with a low TRP availability [9] . As BPV are positively infl uenced by noradrenergic activity [17][18][19][20][21][22][23] , it can be hypothesized that depressed patients with comparatively high BPV have a relatively high noradrenergic function.…”

Section: Discussionsupporting

confidence: 82%

“…Women with seasonal affective disorder seem to have lower BPV than healthy volunteers [7,8] . Recently, a relationship has been found between BPV and the ratio of L -tryptophan (TRP) to the large neutral amino acids (LNAA) in predicting 6-week outcome after antidepressant treatment with the tricyclic drugs desimipramine or clomipramine [9] . The TRP/ LNAA ratio is a measure of TRP availability (as TRP competes with LNAA for entry into the brain) [10] .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Basal Prolactin Values Correlate with Response to Reboxetine Treatment in Major Depression, but Not with Response to Citalopram

Moeller¹,

Hetzel²,

Michael³

et al. 2005

Neuropsychobiology

View full text Add to dashboard Cite

Little is known about variables that might predict outcome in major depression. Recently, basal prolactin values (BPV) have been suggested to predict response to treatment with tricyclic antidepressive drugs. In order to examine whether BPV predict response to selective mono-aminergic therapy, 24 in-patients with major depression were treated in a single-masked, randomised study using the most selective noradrenergic or serotonergic reuptake inhibitors available for antidepressant treatment, i.e. reboxetine and citalopram. A significant correlation between BPV and treatment response to reboxetine was found, but not between BPV and response to citalopram. As BPV are influenced by noradrenergic activity, it can be hypothesized that depressed patients with comparatively high BPV have a relatively high noradrenergic function. This might explain why in our study depressed patients with the highest BPV responded strongest to selective noradrenergic treatment with reboxetine. As measurement of BPV is simple, further studies are suggested to examine the possible clinical value of the link between prolactin, noradrenergic function in major depression and treatment response.

show abstract

Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Basal Prolactin Values Correlate with Response to Reboxetine Treatment in Major Depression, but Not with Response to Citalopram

Moeller¹,

Hetzel²,

Michael³

et al. 2005

Neuropsychobiology

View full text Add to dashboard Cite

show abstract

“…Although we partly employed a within-subject design, and we did not observe any relationships between menstrual cycle phase and the present findings, future studies would preferably have subjects participate in the same phase. Some larger studies of basal and serotonergic challenge-induced plasma prolactin levels found no effect of phase of cycle [61] . The high correlation between the prolactin levels of both conditions, despite a treatment effect on those levels, suggests that many possible state-related confounding effects on prolactin levels exerted only limited influence, such that the prolactin measures showed sufficient reliability and stability to detect individual differences.…”

Section: Discussionmentioning

confidence: 99%

The Psychobiology of Burnout: Are There Two Different Syndromes?

et al. 2007

View full text Add to dashboard Cite

Background: Plasma prolactin levels are sensitive to dopamine and serotonin function, and fatigue. Low cortisol, dopamine and/or serotonin may be involved in burnout and detachment. Methods: In this double-blind within-subject study, we treated 9 female burnout subjects and 9 controls with 35 mg cortisol and placebo orally. We measured state affect and plasma prolactin, oxytocin, cortisol and adrenocorticotropic hormone levels, and administered an attachment questionnaire. Results: The burnout subjects displayed an extreme distribution of basal prolactin levels, displaying higher or lower levels compared to the controls. The low prolactin burnouts had profoundly low attachment scores and tended to have low oxytocin levels. The high prolactin burnout subjects tended to show cortisol-induced decreased prolactin and fatigue, and increased vigor. Conclusion: Results are consistent with the hypothesis that burnout subjects are either characterized by low serotonergic function or by low dopaminergic function, and that the latter group benefits from cortisol replacement. These preliminary results suggest that differentiating between two syndromes may resolve inconsistencies in research on burnout, and be necessary for selecting the right treatment strategy.

show abstract

“…Ein Zusammenhang zwischen Prolaktin, der L-Tryptophan-Verfügbarkeit und antidepressiver Response wurde von Porter et al [43] beschrieben: Bei depressiven Patienten (n=104) mit vergleichsweise geringer L-Tryptophan-Verfügbarkeit fand sich eine statistisch signifikante positive Korrelation zwischen Prolaktin und Ansprechen auf eine 6-wöchige Behandlung mit trizyklischen Antidepressiva, während sich hingegen bei Patienten mit relativ hoher L-Tryptophan-Verfügbarkeit eine statistisch signifikante negative Korrelation zwischen Prolaktin und Ansprechen auf die Therapie fand. Allerdings konnten die Autoren für diese Zusammenhänge keine schlüssige Erklärung liefern.…”

Section: Plasma-markerunclassified

“…Im Gegensatz hierzu zeigte eine andere Studie (n=104) keinen Hinweis für die Hypothese, dass der Prolaktin-oder Kortisolanstieg im Fenfluramin-Stimulationstest einen Prädiktor für eine Response auf Behandlung mit Antidepressiva darstellen könnte [43]. Der große Unterschied in der Fallzahl zwischen den Studien (n=7 vs. n=104) zeigt, dass der Fenfluramin-Stimulationstest als Prädiktor für das Ansprechen auf eine antidepressive Pharmakotherapie ungeeignet erscheint.…”

Section: Neuroendokrine Stimulationstestsunclassified

Monoaminerge Funktion bei depressiven Patienten

2006

View full text Add to dashboard Cite

Little is known about the variables that might predict outcome in major depression. Most studies do not imply any clinical consequences for treatment because their predictors were nonspecific and results did not differ between the different treatment options. Finding a variable that can predict the antidepressive treatment option best suited to an individual might help in reducing the considerable number of nonresponders in the treatment of depression. As most antidepressants influence the serotonergic or noradrenergic system, monoaminergic function at the start of therapy might be a possible specific response predictor. In this review, measures that can determine monoaminergic function are presented along with their relationship to treatment response, e.g., monoaminergic metabolites, neuroendocrine challenge tests, evoked event-related potentials, genetics, and neuroimaging. In conclusion, the results of serotonergic functions are still heterogeneous, but the relationship between noradrenergic function and treatment response has not been investigated in any detail yet.

show abstract

Baseline prolactin and L-tryptophan availability predict response to antidepressant treatment in major depression

Abstract: The PRF did not predict 6-week outcome. BLP and TRP/LNAA ratio measurement is easy and may be useful clinically. We hypothesise that failure to upregulate post-synaptic 5HT receptors in response to low 5HT availability predicts a poor response to antidepressant treatment.

Cited by 20 publications

References 32 publications

Basal Prolactin Values Correlate with Response to Reboxetine Treatment in Major Depression, but Not with Response to Citalopram

Basal Prolactin Values Correlate with Response to Reboxetine Treatment in Major Depression, but Not with Response to Citalopram

The Psychobiology of Burnout: Are There Two Different Syndromes?

Monoaminerge Funktion bei depressiven Patienten

Contact Info

Product

Resources

About