Altered response to meta-chlorophenylpiperazine in anorexia nervosa: Support for a persistent alteration of serotonin activity after short-term weight restoration

Objective: Patients with anorexia nervosa (AN) have disturbances of appetit e and behaviors, such as dysphoria, inhibition, and obsessions, that could be related to altered serotonin activity. To investigate such relationships , we administered metachlorophenylpiperazine (m-CPP), a relatively serotoni n-specific drug. Methods: To avoid the confounding effects of malnutrition or weight loss, we studied 12 patients with restricting-type AN between 5 a nd 17 days after a return to a normal weight and while on a stable dietary intake. We compared them to 12 healthy control women (CW). m-CPP was admini stered double blind and placebo controlled. Results: Although weight restor ed, AN women had lower body weight and increased ratings for depression and obsessionality compared with CW After m-CPP, AN women had an elevation in mood and a reduction in body image distortion when compared with placebo. A fter m-CPP, groups had similar cortisol, adrenocorticotropin (ACTH), and gr owth hormone responses whereas AN women had an uncertain reduction in prola ctin response. Discussion: These data support other studies that suggest th at altered serotonin activity persists after weight restoration in AN patie nts. The finding that m-CPP temporarily improved mood and reduced body imag e distortions supports the hypothesis that altered serotonin activity may c ontribute to the pathophysiology of AN. (C) 2001 by John Wiley & Sons, Inc.