Interrelationship of age, depression, and central serotonergic function: evidence from fenfluramine challenge studies.
Interrelationship of age, depression, and central serotonergic function: evidence from fenfluramine challenge studies.
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DOI：
10.1017/s1041610296002499
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发表时间：
1996-01-01
影响因子：
7
通讯作者：
Shapira, B
中科院分区：
文献类型：
--
作者：
Lerer, B;Gillon, D;Shapira, B
本研究的目的是研究与年龄相关的中枢血清素功能变化与重度抑郁症相关的异常之间的关系。在随机双盲条件下，研究了30名正常人（15名男性，15名女性，年龄21-84岁）和39名内源性重度抑郁症患者（14名男性，25名女性，年龄29-72岁）对血清素释放剂d、l-芬氟拉明（口服60 mg）和安慰剂的泌乳素和皮质醇反应。在正常受试者中，在催乳素反应中观察到显著的年龄x挑战x时间相互作用（p = .03）。这主要是由于年轻健康女性的催乳素反应升高。峰值减去基线（delta）催乳素反应与年龄呈负相关（女性，p = 0.004；男性，p = 0.06）。抑郁症患者对芬氟拉明的催乳素反应无年龄相关性下降。当比较抑郁和健康的年轻受试者时，年轻抑郁症患者对芬氟拉明的delta催乳素反应明显减弱（p = 0.003），而不考虑性别的显著影响（p = 0.01），但在老年抑郁症患者中没有。皮质醇对芬氟拉明的反应没有显示出年龄、性别或诊断的一致影响。与年龄相关的中枢血清素功能下降可能使老年人更容易患抑郁症，并可能使抑郁症发作更频繁，更严重，更难以治疗。
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.