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Biomedical subjects

S L McCance

Publications and source records attributed to S L McCance.

5 recordsLinked to original sources

Lithium in tricyclic-resistant depression. Correlation of increased brain 5-HT function with clinical outcome.

The addition of lithium to the tricyclic antidepressant medication of 23 patients with major depression resulted in an increase in the prolactin response to intravenous L-tryptophan after both four days and four weeks of treatment. The extent of this increase did not distinguish the ten patients who were classified as clinical responders (greater than 50% reduction in score on the HRSD). Among the responders there was a modestly significant correlation between the decrease in score on the HRSD and the enhancement of tryptophan-induced prolactin release. Some responders, however, showed very little change in this endocrine response over the four weeks of lithium treatment. Lithium may increase brain 5-HT function in tricyclic-resistant depression but there is only limited support for the hypothesis that changes in brain 5-HT function are involved in the antidepressant effect of this treatment combination.

Adult↗

5-HT neuroendocrine responses during psychotropic drug treatment: an investigation of the effects of lithium.

Increasing brain 5-hydroxytryptamine (5-HT) function in humans raises plasma concentrations of prolactin, growth hormone and ACTH. Measurement of these hormonal responses provides an index of the functional activity of brain 5-HT pathways. More recent strategies have included the use of directly-acting 5-HT receptor agonists to probe the function of specific receptor subtypes; at present these studies are limited by the questionable selectivity of the agonists employed. Using 5-HT neuroendocrine testing it can be shown that lithium specifically increases the prolactin release mediated by 5-HT pathways. Further studies are needed to determine if this effect is caused by an enhanced sensitivity of post-synaptic 5-HT1A receptors.

Animals↗

Effect of amitriptyline on endocrine responses to intravenous L-tryptophan.

The endocrine responses to the 5-hydroxytryptamine (5HT) precursor, L-tryptophan, were assessed in 10 depressed patients before and after at least 4 weeks of treatment with amitriptyline. Overall, amitriptyline did not alter either prolactin or growth hormone responses to L-tryptophan. When three subjects with severe pretreatment weight loss were excluded, however, the remaining seven patients showed a significant increase in the prolactin response to L-tryptophan, consistent with other published studies. The findings suggest that severe recent weight loss may alter the effects of tricyclic antidepressants on 5HT-mediated prolactin release.

Adult↗

Lithium increases 5-HT-mediated neuroendocrine responses in tricyclic resistant depression.

The addition of lithium to the tricyclic antidepressant medication of 11 depressed patients resulted in an increase in the prolactin response to L-tryptophan after both 4 days and 4 weeks of lithium treatment. There was also a significant fall in Hamilton Depression scores. The results suggest that lithium and tricyclic antidepressants may act synergistically to enhance certain aspects of brain 5-HT function in depressed patients.

Adult↗

Lithium increases 5-HT-mediated prolactin release.

The effects of short-term (3-4 days) lithium treatment on the prolactin responses to intravenous clomipramine (0.1 mg/kg), metoclopramide (5 micrograms/kg) and haloperidol (2.5-5 micrograms/kg) were assessed in male volunteers. Prolactin responses to clomipramine were significantly enhanced by lithium while those following administration of haloperidol and metoclopramide were not significantly altered. Lithium did not change the cortisol response to clomipramine. The results suggest that lithium may selectively enhance 5-HT mediated prolactin release. These data are consistent with the hypothesis that synergistic effects of lithium and clomipramine on brain 5-HT function may be involved in their therapeutic effect in resistant depression.

Clomipramine↗