M. Steiner et al., Serotonergic dysfunction in women with pure premenstrual dysphoric disorder: is the fenfluramine challenge test still relevant?, PSYCHIAT R, 87(2-3), 1999, pp. 107-115
The fenfluramine (FEN) neuroendocrine challenge paradigm, which involves me
asuring the response of prolactin (PRL) release to an oral challenge dose o
f FEN, provides a means of assessing serotonin (5-HT) function. The purpose
of this study was to ascertain the role of 5-HT in premenstrual dysphoric
disorder (PMDD) by measuring: (1) PRL and cortisol (CORT) responses to FEN;
and (2) platelet H-3-imipramine binding levels, in females with pure PMDD
(without a past or present comorbid mood disorder) in comparison to healthy
controls. FEN challenge tests were administered to nine female patients wi
th pure PMDD and nine healthy female controls during the follicular and lat
e luteal phases of a menstrual cycle. There were no differences in the PRL
response to FEN for women with PMDD compared to healthy controls. However,
the trend toward a delayed response to FEN and a significant negative corre
lation between Delta max PRL and basal CORT in patients but not in controls
during both phases of the menstrual cycle suggest an underlying 5-HT dysfu
nction in patients as compared to controls. This is further supported by th
e finding of significantly lower B-max H-3-imipramine binding levels in the
patients during the late luteal phase. (C) 1999 Elsevier Science Ireland L
td. All rights reserved.