Relationship between prolactin responses to ECT and dopaminergic and serotonergic responsivity in depressed patients

Abstract

The prolactin (PRL) increases in plasma, induced by the electrical stimulus during electroconvulsive therapy (ECT), is a consistent finding that can be studied in order to obtain information about its actions on the brain neurotransmitter systems, the most probable candidates being the serotonergic and the dopaminergic system. Central serotonergic and dopaminergic responsivity may also be assessed using neuroendocrine challenge tests. In this study, we measured the PRL responses during the first ECT of a therapeutic course in 15 male depressive patients, of mean age 49.2 +/- 14.5 (range 22 to 68 years), and score in the HDRS of 29 +/- 8 (range 18 to 43 points). Before the ECT course, we assessed the central serotonergic and dopaminergic responsivities, by measuring the PRL responses to the administration of the serotonin uptake inhibitor clomipramine (CMI) intravenously, and, two days later, the PRL responses dopamine receptor blocker haloperidol (HAL), administered intramuscularly. The CMI and HAL tests were also performed in 15 healthy male subjects. The PRL responses to CMI of the patients were blunted compared to healthy controls, while the PRL responses to HAL were not significantly different from controls. Searching for correlations among the maximal PRL responses to the three stimuli in the patient's group, we found that the PRL responses to ECT were significantly correlated to the PRL responses to i. m. HAL (r = 0.8205, N = 15, p < 0.001) and not to the PRL responses to i. v. CMI (r = 0.1713, n. s.). It is suggested that the rises in PRL during ECT reflect the responsivity of the hypothalamus-pituitary dopaminergic system, and seem to be the result of a transient decrease in the inhibitory dopaminergic input of the hypothalamus to the pituitary lactotrophs, caused by the electrical stimulus and the subsequent seizure.

The Case of a Depressed Man Who Exhibited Hyperprolactinemia and Galactopoiesis After Electroconvulsive Therapy

“…1 Here, we present a case of depression hyperprolactinemia and galactopoiesis induced by ECT. 1 Here, we present a case of depression hyperprolactinemia and galactopoiesis induced by ECT.…”

Sex-specific factors associated with lifetime suicide attempt among patients with alcohol use disorders

“…Furthermore, suicide attempt in AUD patients has been found to be related to neurobiological factors, including serotonin 15 and dopamine 16 dysregulation, which in turn may be attributed to alcohol use and are manifested, for instance, as a derangement in levels of circulating prolactin. 17 Dopamine and serotonin exert regulatory functions over level of prolactins through inhibitory and stimulatory mechanisms, respectively. Possible sex differences in factors related to suicidal behaviour, mainly suicide attempt among patients with AUD AUD patients are heterogenous and may be better understood when studied in subgroups.…”

“…46 As mentioned earlier, levels of prolactin may be related to dopamine and serotonin, with the former having an inhibitory effect and the latter a stimulatory effect on prolactin release. 17 It has been proposed that a combination of low serotonin and high dopamine function serves as a neurobiological trait in predisposing impulsive aggression, and this in turn is associated with suicidality. 47 Moreover, impulsive aggression is characteristic of ASPD, and in our study ASPD was also related to suicide attempt.…”

Hippocampal Neurogenesis and Antidepressive Therapy: Shocking Relations

“…The involvement of additional cerebral structures, such as the amygdala, the frontal cortex, and the thalamus, has been well documented in studies revealing structural abnormalities and disbalances of neurotransmitters [33–35]. Hence, ECT is likely to act on numerous cerebral structures, possibly stimulating their neuronal plasticity.…”