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Parenteral clomipramine challenge in depressed adolescents: mood and neuroendocrine response
F R Sallee1, N S Vrindavanam, D Deas-Nesmith
1Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29403, USA.
Background:
Major depressive disorder (MDD) in the adolescent demonstrates a unique clinical profile, and pathogenic serotonergic dysregulation is hypothesized. Parenteral clomipramine (CMI) is known to distinguish adult MDD from control, but neurochallenge data are lacking in adolescent MDD.
Methods:
Thirteen drug-free outpatient adolescents who met DSM-III-R criteria for MDD were compared to adolescent controls by acute neuroendocrine and mood response to 12.5 mg of parenteral CMI.
Results:
Repeated measures analysis revealed significant changes from baseline for sadness (p < .01) between groups, with normal controls increasing sadness rating after CMI. Prolactin (PRL) maximum change score from baseline was decreased in MDD relative to controls (p < .05). Gender effects on PRL were evident in controls but not in MDD.
Conclusions:
The findings of PRL blunting in adolescent MDD mirrors previous work in adults. A unique finding is the induction of sadness in normal adolescent controls after CMI infusion.