PROLACTIN RESPONSE TO FENFLURAMINE AND PLACEBO CHALLENGE FOLLOWING MAINTENANCE PHARMACOTHERAPY WITHDRAWAL IN REMITTED DEPRESSED-PATIENTS

Plasma prolactin (PRL) response to fenfluramine (FF) (60 mg orally) an d placebo challenge was examined in eight remitted depressed patients who were withdrawn for 14 days from maintenance pharmacotherapy with c lomipramine (CMI) plus lithium carbonate (Li) (n = 6) or Li alone (n = 2), 6 months after recovering from their major depressive episode. Th e patients had undergone identical FF challenge tests while drug free prior to commencing treatment with electroconvulsive therapy (ECT) (n = 4) or CMI supplemented with Li (n = 4) and after completing the abov e treatments. PRL response to FF in the remitted, drug-free state was significantly enhanced compared to the response prior to treatment (wh ile depressed and drug-free) and not significantly different from the response following treatment with ECT (n = 4) or CMI plus Li (n = 4) 6 months before. Other work of a similar nature supports the view that enhanced serotonergically mediated hormone release in drug-withdrawn, remitted depressives, represents a long-standing change in central ser otonergic responsiveness and not a continued effect of antidepressant treatment or a manifestation of medication withdrawal.