INTRAVENOUS CLOMIPRAMINE CHALLENGE IN OBSESSIVE-COMPULSIVE DISORDER -PREDICTING RESPONSE TO ORAL-THERAPY AT 8 WEEKS

Background: Challenge with intravenous clomipramine (CMI) is serotonin selective and has been reported to transiently exacerbate symptoms in obsessive-compulsive disorder (OCD) patients, and to predict subseque nt response to oral CMI therapy. Methods: We administered CMI (12.5 mg , IV) to medication free OCD patients (N = 29) and normal controls (N = 22) to characterize neurohormonal response, A subset of OCD patients (26/29), was then treated with either pulse load N or oral CMI follow ed by 8 weeks of or-al CMI therapy. Results: In response to CMI challe nge, OCD patients exhibit blunted cortisol and exaggerated growth horm one response relative to normal controls, OCD patients differ from con trols in ''sadness'' ratings, with controls exhibiting increased dysph oria in response to CMI, Growth hormone response to CMI challenge pred icts treatment response (greater than or equal to 25% down arrow YBOCS from baseline) to oral CMI at 8 weeks. Conclusions: Growth hormone ab normalities associated with OCD in response to CMI challenge different iates nonresponders after 8 weeks of ol al CMI treatment from responde rs. (C) 1998 Society of Biological Psychiatry.