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Behavioral and Neuroendocrine Responses to Oral m-Chlorophenylpiperazine and Fenfluramine in Patients and Healthy Volunteers

Eric Hollander, MD; Concetta M. DeCaria, MS; Anca Nitescu, MA; Robert Gully; Raymond F. Suckow, PhD; Thomas B. Cooper, MA; Jack M. Gorman, MD; Donald F. Klein, MD; Michael R. Liebowitz, MD

Arch Gen Psychiatry. 1992;49(1):21-28.

Abstract
• To evaluate serotonergic (5-hydroxytryptamine) function in obsessive-compulsive disorder, behavioral and neuroendocrine responses to m-chlorophenylpiperazine (m-CPP; 0.5 mg/kg orally) and fenfluramine hydrochloride (60 mg orally) were examined in 20 patients and 10 healthy controls under double-blind, placebo-controlled conditions. Following m-CPP, but not fenfluramine or placebo, 55% (11/20) of the patients with obsessive-compulsive disorder experienced a transient exacerbation of obsessivecompulsive disorder. Prolactin response was blunted in patients following m-CPP but not following fenfluramine. Patients with greater behavioral response to m-CPP had smaller prolactin responses. Cortisol response to m-CPP and fenfluramine did not significantly differ between the groups. Behavioral and neuroendocrine responses appeared divergent. This does not suggest simply upregulation or downregulation of 5-hydroxytryptamine receptors, but rather complex mechanisms involving multiple neurotransmitter and neuromodulator systems.

Author Affiliations
From the Department of Psychiatry, College of Physicians and Surgeons of Columbia University and the Obsessive-Compulsive Disorder Biological Studies Program, New York State Psychiatric Institute, New York.

Footnotes
Accepted for publication February 21, 1991.

Reprint requests to New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr Hollander).

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