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Interrelationship of Age, Depression, and Central Serotonergic Function: Evidence From Fenfluramine Challenge Studies

Published online by Cambridge University Press:  07 January 2005

Bernard Lerer
Affiliation:
Biological Psychiatry Laboratory, Department of Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel Department of Psychiatry, Hebrew University-Hadassah Medical School, Jerusalem, Israel
Dan Gillon
Affiliation:
Department of Cardiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Pesach Lichtenberg
Affiliation:
Department of Psychiatry, Hebrew University-Hadassah Medical School, Jerusalem, Israel Depression Treatment Unit, Herzog Hospital, Jerusalem, Israel.
Malka Gorfine
Affiliation:
Department of Psychiatry, Hebrew University-Hadassah Medical School, Jerusalem, Israel Laboratory of Applied Statistics, Department of Statistics, Hebrew University, Jerusalem, Israel
Yevgenia Gelfin
Affiliation:
Biological Psychiatry Laboratory, Department of Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel Department of Psychiatry, Hebrew University-Hadassah Medical School, Jerusalem, Israel
Baruch Shapira
Affiliation:
Department of Psychiatry, Hebrew University-Hadassah Medical School, Jerusalem, Israel Depression Treatment Unit, Herzog Hospital, Jerusalem, Israel.

Abstract

The purpose of this study was to examine the relationship between age-associated changes in central serotonergic function and abnormalities associated with major depression. Under randomized double-blind conditions, prolactin and cortisol responses to the serotonin-releasing agent d,l-fenfluramine hydrochloride (60 mg orally) and placebo were examined in 30 normal subjects (15 men, 15 women; age range 21–84 years) and 39 patients with major depressive disorder, endogenous subtype (14 men, 25 women; age range 29–72 years). In the normal subjects, a significant Age x Challenge x Time interaction was observed in the prolactin response (p = .03). This was primarily due to the elevated prolactin responses of the younger healthy women. Peak minus baseline (delta) prolactin responses were negatively correlated with age (women, p = .004; men, p = .06). In the depressed patients there was no age-related decline in prolactin response to fenfluramine. When depressed and healthy younger subjects were compared, delta prolactin responses to fenfluramine were significantly blunted in young patients with depression (p = .003) irrespective of the significant effect of gender (p = .01), but not in older depressed patients. Cortisol responses to fenfluramine did not reveal consistent effects of age, gender, or diagnosis. Age-related decline in central serotonergic function may make older individuals more vulnerable to depression and possibly render depressive episodes more frequent, more severe, and less amenable to treatment.

Type
Research and Reviews
Copyright
© 1996 International Psychogeriatric Association

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