Prolactin response to buspirone challenge in the presence of dopaminergic blockade

Buspirone-stimulated prolactin release has been employed as an indirect measure of central serotonin activity; however, it is not clear whether serotonergic or dopaminergic systems are responsible for this response. In an attempt to further elucidate the mechanism, we studied the prolactin response to buspirone in eight subjects in the presence of maximal dopaminergic receptor blockade with metoclopramide under placebo-controlled, double-blind conditions. The prolactin response to buspirone in the presence of metoclopramide was not statistically different from that to placebo under the same conditions. The demonstration of further prolactin release by a bolus of thyrotropin-releasing hormone under maximal dopaminergic receptor blockade provided evidence against potential pituitary prolactin depletion by metoclopramide. These results lend further support to a dopaminergic mechanism in buspirone-induced prolactin secretion; therefore, further caution is warranted in interpreting the results of this challenge test as a measure of serotonergic activity in the brain.