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Prolactin Response to Fenfluramine and Suicide Attempt Lethality in Major Depression

Published online by Cambridge University Press:  02 January 2018

Kevin M. Malone ,
Elizabeth M. Corbitt ,
Shuhua Li  and
J. John Mann
Kevin M. Malone*
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, and Department of Neuroscience, New York State Psychiatric Institute
Elizabeth M. Corbitt
Affiliation:
Department of Psychiatry, University of Pittsburgh
Shuhua Li
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, and Department of Neuroscience, New York State Psychiatric Institute
J. John Mann
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, and Department of Neuroscience, New York State Psychiatric Institute
*
Dr K. M. Malone, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, and New York State Psychiatric Institute, MHCRC for the Study of Suicidal Behaviour, Room 1501, Box 28, 722 West 168th Street, New York, NY 10032. Fax: (212) 795-8659
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Abstract

Background

This study employed an alternative method for assessing serotonergic function to further evaluate our finding that cerebrospinal fluid (CSF) 5-hydroxyindole acetic acid (5-HIAA) in depressed suicide attempters with a lifetime history of higher lethality suicide attempts is significantly lower compared to depressed patients who have a history of low lethality suicide attempts.

Method

We used dl-fenfluramine (60 mg) as a neuroendocrine probe to examine the serotonin system in 41 in-patients with a DSM–III–R major depressive episode, divided into two groups on the basis of a lifetime history of high or low lethality suicide attempts. Fenfluramine challenge test outcome was defined as the maximum prolactin response in the five hours following fenfluramine.

Results

Patients with a history of a higher lethality suicide attempt had a significantly lower prolactin response to fenfluramine, even when controlling for cortisol, age, sex, weight, comorbid cluster B personality disorder, pharmacokinetic and menstrual cycle effects.

Conclusions

The data provide further support for the hypothesis that serotonin dysfunction is associated with more lethal suicide attempts, and suggests that higher lethality suicide attempters or failed suicides resemble completed suicides both behaviourally and biochemically.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue 3 , March 1996 , pp. 324 - 329
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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