Implications of impulsive and affective symptoms for serotonin function inbulimia nervosa

Background. Bulimic, impulsive and depressive syndromes have all been assoc iated with abnormalities in brain serotonin (5-hydroxytryptamine; 5-HT) mec hanisms. Methods. We had 26 bulimic women and 22 normal-eater women report impulsive , affective, self-destructive and bulimic symptoms, and then provide serial blood samples for measurement of: [3H]-paroxetine binding in platelets; an d, prolactin (PRL) responses following oral meta-chlorophenyl-piperazine (m -CPP). Results. Bulimic status was associated with markedly reduced density of par oxetine-binding sites, modest blunting of m-CPP stimulated PRL response, an d greater nausea following m-CPP. Biological variables did not co-vary with most psychopathological or eating-symptom indices. However: there were inv erse associations (in bulimic women only) between scores indicating impulsi vity (largely 'unreflectiveness') and density of platelet 5-HT uptake sites . Conclusions. Our observations link bulimia nervosa to altered 5-HT function ing, and suggest that there may be a relatively symptom-specific associatio n between impulsivity and reduced 5-HT reuptake.