Leo Sher, M.D.

Our research work, “Serotonergic responses in depressed patients with or without a history of alcohol use disorders and healthy controls” was published 15 years ago, in the September 2008 issue of European Neuropsychopharmacology (1).

To compare serotonin function in major depressive disorder with co-occurring alcohol use disorder, major depressive disorder without co-occurring alcohol use disorder and healthy controls we sought to study differences in prolactin responses to fenfluramine administration in patients major depressive disorder with co-occurring alcohol use disorder, patients with major depressive disorder without co-occurring alcohol use disorder and healthy controls. Because the serotonergic system is involved in the etiopathogenesis of both depression and alcoholism, fenfluramine administration is an important research tool in studies of depressive and alcohol use disorders.

The major depressive disorder with co-occurring alcohol use disorder group consisted of 62 patients (34 males and 28 females), the major depressive disorder without co-occurring alcohol use disorder group consisted of 75 patients (27males and 48 females), and the healthy controls group consisted of 32 subjects (19 males and 13 females). Depressed patients had a score of 16 or more on the 17-item Hamilton Depression Rating Scale. Subjects were administered D,L-fenfluramine orally. Blood samples were drawn 15 minutes before capsule administration, at the time of administration of the capsule and then hourly for 5 hours. Blood samples were analyzed for prolactin, fenfluramine, and norfenfluramine levels. The study was single-blind.

Controlling for gender, prolactin responses were lower in the major depressive disorder with co-occurring alcohol use disorder group compared to the major depressive disorder without co-occurring alcohol use disorder or the healthy controls group. Controlling for gender and aggression, prolactin responses in the major depressive disorder with co-occurring alcohol use disorder group remained significantly lower compared to the healthy controls group but the difference between the major depressive disorder with co-occurring alcohol use disorder and the major depressive disorder without co-occurring alcohol use disorder only groups disappeared. Our results suggest that the difference in prolactin responses could be attributed to higher aggression scores in the major depressive disorder with co-occurring alcohol use disorder group compared to the major depressive disorder without co-occurring alcohol use disorder group.

Reference

1. Sher L, Stanley BH, Cooper TB, Malone KM, Mann JJ, Oquendo MA. Serotonergic responses in depressed patients with or without a history of alcohol use disorders and healthy controls. Eur Neuropsychopharmacol. 2008 Sep;18(9):692-9. doi: 10.1016/j.euroneuro.2008.05.005. Epub 2008 Jun 30.