Functional interrelationship of serotonin and norepinephrine: Cortisol response to MCPP and DMI in patients with panic disorder, patients with depression, and normal control subjects

Gregory M. Asnis, Scott Wetzler, William C. Sanderson, RenéS S. Kahn, Herman M. van Praag

Research output: Contribution to journalArticle

35 Scopus citations


The relationship between norepinephrine (NE) and serotonin (5-hydroxytryptamine; 5HT) functioning was explored in a neuroendocrine challenge paradigm. Ten normal control subjects, 17 patients with major depression, and 22 patients with panic disorder volunteered to participate in this study. Each subject received a challenge with meta-chlorophenylpiperazine (MCPP; 0.25 mg/kg, p.o.), a 5HT agonist, and desmethylimipramine (DMI; 75 mg, i.m.), an indirect NE agonist, in randomized order. The peak-minus-baseline cortisol response to MCPP was used as an indicator of 5HT function, and cortisol response at 75 minutes-minus-baseline to DMI was used as an indicator of NE function. The cortisol responses to DMI and MCPP were found to be highly negatively correlated in the total sample, in particular in the patients with major depression and panic disorder. This findings suggests that the functions (or dysfunctions) of the NE and 5HT systems may not be separate as is usually believed, and that the NE and 5HT disturbances observed in major depression and panic disorder may not be independent. Rather, there may be a joint disturbance of NE-5HT in these disorders.

Original languageEnglish (US)
Pages (from-to)65-76
Number of pages12
JournalPsychiatry Research
Issue number1
StatePublished - Jul 1992



  • Major affective disorder
  • anxiety
  • desmethylimipramine
  • meta-chlorophenylpiperazine
  • psychoneuroendocrine challenges

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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