Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder

Sanjay J. Mathew, Jeremy D. Coplan, Kathryn A. Perko, Raymond R. Goetz, Manuel De La Neuz, Eric Hollander, Michael R. Liebowitz, Brian A. Fallon

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The current study examines the neuroendocrine response to intravenous clomipramine (IV CMI) in oral CMI-resistant obsessive-compulsive disorder (OCD) patients on day 1 and day 14 of treatment to identify predictors of response. Forty-four OCD patients with an inadequate response or poorly tolerant to oral CMI were begun at 25 mg IV CMI, increasing to 250 mg by day 10, and continuing on that dose to day 14. On day 1, plasma levels of prolactin (PRL), growth hormone (GH), and cortisol were obtained immediately before the 25 mg IV infusion, and at five 30-minute time points after the infusion. On day 14, hormonal samples were obtained in a similar fashion. Response was assessed by the Clinical Global Impressions (CGI). Low PRLMAX to IV CMI and low cortisol levels overall on day 1 were both significantly associated with clinical response at day 14. An overall increase in growth hormone (GH) secretion during the day 14 testing was associated with positive response. A pronounced PRL response to IV CMI on day 14 was exhibited by the nonresponders, whereas a smaller and later but significant increase in PRL was noted in the responders. The findings suggest that in this sample of oral CMI-resistant patients with OCD, neuroendocrine measures derived from pharmacological challenge with IV CMI are capable of distinguishing IV CMI treatment responders from nonresponders. The limitations of IV CMI as a specific probe of serotonin function are discussed.

Original languageEnglish (US)
Pages (from-to)199-208
Number of pages10
JournalDepression and Anxiety
Volume14
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Clomipramine
Obsessive-Compulsive Disorder
Prolactin
Therapeutics
Growth Hormone
Hydrocortisone
Serotonin
Pharmacology

Keywords

  • Cortisol
  • Growth hormone
  • Intravenous clomipramine
  • Obsessive compulsive disorder
  • Pharmacological challenge
  • Prolactin

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)
  • Clinical Psychology

Cite this

Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder. / Mathew, Sanjay J.; Coplan, Jeremy D.; Perko, Kathryn A.; Goetz, Raymond R.; De La Neuz, Manuel; Hollander, Eric; Liebowitz, Michael R.; Fallon, Brian A.

In: Depression and Anxiety, Vol. 14, No. 4, 2001, p. 199-208.

Research output: Contribution to journalArticle

Mathew, SJ, Coplan, JD, Perko, KA, Goetz, RR, De La Neuz, M, Hollander, E, Liebowitz, MR & Fallon, BA 2001, 'Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder', Depression and Anxiety, vol. 14, no. 4, pp. 199-208. https://doi.org/10.1002/da.1067
Mathew, Sanjay J. ; Coplan, Jeremy D. ; Perko, Kathryn A. ; Goetz, Raymond R. ; De La Neuz, Manuel ; Hollander, Eric ; Liebowitz, Michael R. ; Fallon, Brian A. / Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder. In: Depression and Anxiety. 2001 ; Vol. 14, No. 4. pp. 199-208.
@article{c535328ef0a44155a338cc986861f523,
title = "Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder",
abstract = "The current study examines the neuroendocrine response to intravenous clomipramine (IV CMI) in oral CMI-resistant obsessive-compulsive disorder (OCD) patients on day 1 and day 14 of treatment to identify predictors of response. Forty-four OCD patients with an inadequate response or poorly tolerant to oral CMI were begun at 25 mg IV CMI, increasing to 250 mg by day 10, and continuing on that dose to day 14. On day 1, plasma levels of prolactin (PRL), growth hormone (GH), and cortisol were obtained immediately before the 25 mg IV infusion, and at five 30-minute time points after the infusion. On day 14, hormonal samples were obtained in a similar fashion. Response was assessed by the Clinical Global Impressions (CGI). Low PRLMAX to IV CMI and low cortisol levels overall on day 1 were both significantly associated with clinical response at day 14. An overall increase in growth hormone (GH) secretion during the day 14 testing was associated with positive response. A pronounced PRL response to IV CMI on day 14 was exhibited by the nonresponders, whereas a smaller and later but significant increase in PRL was noted in the responders. The findings suggest that in this sample of oral CMI-resistant patients with OCD, neuroendocrine measures derived from pharmacological challenge with IV CMI are capable of distinguishing IV CMI treatment responders from nonresponders. The limitations of IV CMI as a specific probe of serotonin function are discussed.",
keywords = "Cortisol, Growth hormone, Intravenous clomipramine, Obsessive compulsive disorder, Pharmacological challenge, Prolactin",
author = "Mathew, {Sanjay J.} and Coplan, {Jeremy D.} and Perko, {Kathryn A.} and Goetz, {Raymond R.} and {De La Neuz}, Manuel and Eric Hollander and Liebowitz, {Michael R.} and Fallon, {Brian A.}",
year = "2001",
doi = "10.1002/da.1067",
language = "English (US)",
volume = "14",
pages = "199--208",
journal = "Depression and Anxiety",
issn = "1091-4269",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder

AU - Mathew, Sanjay J.

AU - Coplan, Jeremy D.

AU - Perko, Kathryn A.

AU - Goetz, Raymond R.

AU - De La Neuz, Manuel

AU - Hollander, Eric

AU - Liebowitz, Michael R.

AU - Fallon, Brian A.

PY - 2001

Y1 - 2001

N2 - The current study examines the neuroendocrine response to intravenous clomipramine (IV CMI) in oral CMI-resistant obsessive-compulsive disorder (OCD) patients on day 1 and day 14 of treatment to identify predictors of response. Forty-four OCD patients with an inadequate response or poorly tolerant to oral CMI were begun at 25 mg IV CMI, increasing to 250 mg by day 10, and continuing on that dose to day 14. On day 1, plasma levels of prolactin (PRL), growth hormone (GH), and cortisol were obtained immediately before the 25 mg IV infusion, and at five 30-minute time points after the infusion. On day 14, hormonal samples were obtained in a similar fashion. Response was assessed by the Clinical Global Impressions (CGI). Low PRLMAX to IV CMI and low cortisol levels overall on day 1 were both significantly associated with clinical response at day 14. An overall increase in growth hormone (GH) secretion during the day 14 testing was associated with positive response. A pronounced PRL response to IV CMI on day 14 was exhibited by the nonresponders, whereas a smaller and later but significant increase in PRL was noted in the responders. The findings suggest that in this sample of oral CMI-resistant patients with OCD, neuroendocrine measures derived from pharmacological challenge with IV CMI are capable of distinguishing IV CMI treatment responders from nonresponders. The limitations of IV CMI as a specific probe of serotonin function are discussed.

AB - The current study examines the neuroendocrine response to intravenous clomipramine (IV CMI) in oral CMI-resistant obsessive-compulsive disorder (OCD) patients on day 1 and day 14 of treatment to identify predictors of response. Forty-four OCD patients with an inadequate response or poorly tolerant to oral CMI were begun at 25 mg IV CMI, increasing to 250 mg by day 10, and continuing on that dose to day 14. On day 1, plasma levels of prolactin (PRL), growth hormone (GH), and cortisol were obtained immediately before the 25 mg IV infusion, and at five 30-minute time points after the infusion. On day 14, hormonal samples were obtained in a similar fashion. Response was assessed by the Clinical Global Impressions (CGI). Low PRLMAX to IV CMI and low cortisol levels overall on day 1 were both significantly associated with clinical response at day 14. An overall increase in growth hormone (GH) secretion during the day 14 testing was associated with positive response. A pronounced PRL response to IV CMI on day 14 was exhibited by the nonresponders, whereas a smaller and later but significant increase in PRL was noted in the responders. The findings suggest that in this sample of oral CMI-resistant patients with OCD, neuroendocrine measures derived from pharmacological challenge with IV CMI are capable of distinguishing IV CMI treatment responders from nonresponders. The limitations of IV CMI as a specific probe of serotonin function are discussed.

KW - Cortisol

KW - Growth hormone

KW - Intravenous clomipramine

KW - Obsessive compulsive disorder

KW - Pharmacological challenge

KW - Prolactin

UR - http://www.scopus.com/inward/record.url?scp=0035662448&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035662448&partnerID=8YFLogxK

U2 - 10.1002/da.1067

DO - 10.1002/da.1067

M3 - Article

VL - 14

SP - 199

EP - 208

JO - Depression and Anxiety

JF - Depression and Anxiety

SN - 1091-4269

IS - 4

ER -