Electroconvulsive Therapy and Prolactin Release: Relation to Treatment Response in Melancholia

Serum prolactin levels 15 min after each of four consecutive electroconvulsive treatments (ECTs) in 16 male melancholics fell from the first to the fourth treatment. A larger mean prolactin response to ECT correlated with a slower treatment response, as measured by global outcome ratings after six ECTs and the total number of ECTs administered, both blind to prolactin levels. These findings were independent of baseline prolactin levels or treatment electrode placement; they are consistent with the hypothesis that ECT increases postsynaptic dopamine receptor sensitivity. Although intriguing, they await confirmation in a larger sample.