The prolactin response to sulpiride in major depression: the role of the D-2 receptor in depression

Multiple lines of investigations have implicated the role of the dopaminerg ic system in depression. The aim of the study was to characterise the Dopam ine D-2 receptor sensitivity status in depressed patients versus controls b y means of a novel neuro-endocrine challenge test, the prolactin response t o sulpiride. In this intervention, ten patients and ten age matched male vo lunteers were studied. The patients were diagnosed according to DSM-IV crit eria, and Montgomery Asberg and Zung scales were done. There was no signifi cant difference in baseline levels of prolactin between the depressed and c ontrol groups. Significantly higher prolactin levels after sulpiride challe nge were however found in depressed patients than controls at all time poin ts after sulpiride administration. This neuroendocrine challenge paradigm s uggests that the prolactin response to sulpiride, a D-2 receptor antagonist , is enhanced in depression, which suggests that this receptor might be sup ersensitive in depression compared to controls. This adds to the data impli cating the dopaminergic system in the pathophysiology of depression, and su ggests that dopaminergic mechanisms might be a target of therapeutic intere st. (C) 2001 Elsevier Science B.V./ECNP. All rights reserved.