The recent study of Denys et al. (
1
) prompts us to draw attention to several non-serotonergic effects of selective serotonin
reuptake inhibitors (SSRIs), including dopaminergic effects. Denys et al. reported two major findings from a post hoc analysis of three quetiapine augmentation
studies in 102 obsessive-compulsive disorder (OCD) patients treated with SRIs. Firstly,
therapeutic benefit from augmentation depended on the particular SRI used, with response
observed only in patients taking fluoxetine, fluvoxamine, and clomipramine. Secondly,
lower dosage of SRIs was associated with greater benefit from augmentation in this
study. The observations are novel, interesting, and deserve further discussion. Starting
with limitations of the prevailing serotonergic perspective on OCD, we will add some
interrelated considerations regarding firstly dopaminergic effects of SSRIs, secondly
pharmacokinetics of SSRI, and thirdly influences of symptom profile on outcome.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Quetiapine addition in obsessive-compulsive disorder: Is treatment outcome affected by type and dose of serotonin reuptake inhibitors?.Biol Psychiatry. 2007; 61: 412-414
- “Dopamine-dependent” side effects of selective serotonin reuptake inhibitors: A clinical review.J Clin Psychiatry. 2004; 65: 1064-1068
- Selective increase of dopamine D3 receptor gene expression as a common effect of chronic antidepressant treatments.Mol Psychiatry. 2000; 5: 378-388
- Fluvoxamine treatment and D2 receptors: A pet study on OCD drug-naive patients.Neuropsychopharmacology. 2007; 32: 197-205
- Symptom remission in OCD after discontinuation of pharmacotherapy with fluoxetine: A case for looking beyond serotonin.Prog Neuropsychopharmacol Biol Psychiatry. 2007; 31: 959-960
- Synergistic dopamine increase in the rat prefrontal cortex with the combination of quetiapine and fluvoxamine.Psychopharmacology. 2004; 176: 195-203
- Tryptophan depletion and its implications for psychiatry.Br J Psychiatry. 2001; 178: 399-405
Article info
Publication history
Published online: August 15, 2007
Identification
Copyright
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Quetiapine Addition in Obsessive-Compulsive Disorder: Is Treatment Outcome Affected by Type and Dose of Serotonin Reuptake Inhibitors?Biological PsychiatryVol. 61Issue 3
- ReplyBiological PsychiatryVol. 63Issue 1
- PreviewWe are grateful to Dr. Zurowski et al. for their interest in our article. They noted problems in the serotonin hypothesis and advantages in the dopamine hypothesis of obsessive–compulsive disorder (OCD), pointed out dopaminergic effects of selective serotonin reuptake inhibitors (SSRIs), and suggested that pharmacokinetics and symptom profiles accounted for our findings.
- Full-Text
- Preview
