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Hypofunction of the serotonin (5-HT) system might be involved in depression. Initial
effects of the 5-HT reuptake inhibitor clomipramine (CMI) on plasma 5-HT have never
been assessed. On Day 1, 27 depressed patients received either a 25-mg CMI slow infusion
or a 25-mg CMI tablet in a randomized, double-blind, double-dummy design. The daily
dose was subsequently titrated up to 75 mg i.v. or 150 mg orally. The Montgomery-Asberg
Depression Rating Scale (MADRS) was rated on Days 1, 4, 7 and 14. High-performance
liquid chromatography (HPLC-EC) assays of plasma 5-HT, platelet 5-HT, and CMI were
performed on Day 1 before and after the infusion. On Day 1, both groups experienced
a mean (nonsignificant) plasma 5-HT increase; in the i.v. group this initial increase
correlated with MADRS decrease over 14 days (r = 0.76, p = .0025). Correlations between platelet 5-HT and MADRS decrease were not significant.
These preliminary data show that: i) CMI administration results in initial changes
in plasma 5-HT; and ii) i.v. CMI-induced initial plasma 5-HT increase is consistent
with the CMI 5-HT profile, and might predict the clinical response to CMI.
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Article info
Publication history
Received in revised form:
August 10,
1995
Received:
October 25,
1993
Identification
Copyright
© 1996 Society of Biological Psychiatry. Published by Elsevier Inc.