Behavioral responses to intravenous meta-chlorophenyl- piperazine in patients with seasonal affective disorder and control subjects before and after phototherapy

doi:10.1016/0165-1781(94)90087-6

Psychiatry Research

Volume 52, Issue 2, May 1994, Pages 181-197

https://doi.org/10.1016/0165-1781(94)90087-6 Get rights and content

Abstract

A comparison of the baseline and post-infusion effects of the serotonin agonist meta-chlorophenylpiperazine (m-CPP) in 10 patients with seasonal affective disorder (SAD) and 11 healthy control subjects revealed significantly different subjective response profiles between the groups. Several baseline and m-CPP- stimulated responses in symptoms putatively related to serotonergic function changed significantly after a week's exposure to phototherapy in the SAD patients but not the control subjects. Before phototherapy, depressed patients with SAD reported activation-euphoria responses to m-CPP and significant decreases in carbohydrate hunger, but insignificant changes in feeling slowed or sleepy, while control subjects reported no mood or appetite changes but significant increases in feeling slowed down following m-CPP. After phototherapy, which led to a significant reduction in baseline depressive symptom ratings to near-euthymic levels in the SAD patients, almost all of the patients' responses to m-CPP were normalized and no longer differed from the control subjects' responses. These results provide evidence of a possible dysregulation in serotonergic neurotransmission in depressed SAD patients that normalizes following treatment with phototherapy.

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Bright light exposure during acute tryptophan depletion prevents a lowering of mood in mildly seasonal women
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We investigated the influence of bright light exposure on the mood-lowering effect of acute tryptophan depletion (ATD). Mildly seasonal healthy young women without a personal or family history of psychiatric disorders remained in either dim or bright light during two test days. Tryptophan-deficient and nutritionally balanced amino acid mixtures were administered in counterbalanced order. Mood state was assessed using the Profile of Mood States (POMS) and Visual Analogue Scales (VAS). In dim light, ATD decreased POMS scores across most subscales, indicating a worsening of mood. In bright light, mood was unaffected by ATD. Thus, bright light blocked the worsening of mood caused by ATD. This was also observed on the positive mood VAS. These results indicate a direct, immediate interaction between bright light and serotonin function. Bright light might help protect against ATD-induced mood change by increasing serotonin above the threshold level below which there is a lowering of mood.
Is there circannual variation of human platelet 5-HT<inf>2A</inf> binding in depression?
2002, Journal of Affective Disorders
Background: Seasonal variations in onset of mood disorders and in serotonergic function are reported, but their relationship is unclear. Methods: Circannual variation in platelet 5-HT_2A binding was measured in 68 healthy subjects and 121 patients with a major depressive episode. In 73 patients the current episode began during Spring or Fall. Results: Significant, but different, circannual variations were found in patients compared with controls. Controls had two peaks of B_max, one in Spring and another in Fall. Fall and Winter K_D was 41% lower compared with Spring and Summer K_D. Patients had a peak of B_max in early Spring and a lesser one in late Fall. B_max during Spring and Fall was 12% higher compared with Winter and Summer. K_D was higher during October through February compared with the rest of the year. B_max in patients was higher compared with controls in March. The opposite difference was observed in September–December. These differences from controls were mostly due to patients with an onset of the current major depressive episode during Spring or Fall. Conclusions: Patients with a major depressive episode differed from controls in circannual variation of platelet 5-HT_2A binding. This may reflect a vulnerability to seasonal effects in patients with mood disorders.
Sleep deprivation as a predictor of response to light therapy in major depression
2001, Journal of Affective Disorders
Background: While the majority of depressed patients benefit from total sleep deprivation (TSD), light therapy is regarded as a first-line treatment only for seasonal affective disorder (SAD). The results of light therapy in nonseasonal major depressive disorder have been non-conclusive. We examined the correlation of TSD response and light therapy response in major depressed patients. Methods: 40 inpatients with major depressive disorder (seven with seasonal pattern, 33 without seasonal pattern) were deprived of a night’s sleep. The TSD responders, as well as the TSD nonresponders, were randomly assigned to receive adjunct light therapy either with bright white light (2500 lux) or dim red light (50 lux) during 2 weeks beginning on the third day after TSD. Results: The 20 TSD responders improved significantly better under the light therapy than the 20 TSD nonresponders (according to the Hamilton Depression Rating Scale and the self-rating depression scale Bf-S; v. Zerssen). Limitations: No significant difference could be found between the two light intensities. Since the patients were additionally treated with medication an interaction with the two adjunctive therapies cannot be excluded. Conclusion: Our results indicate that a positive TSD response in major depressed patients can be predicative of beneficial outcome of subsequent light therapy.
Genetic studies of seasonal affective disorder and seasonality
2001, Comprehensive Psychiatry
Genetic studies of seasonal affective disorder (SAD) and seasonality have received considerable attention over the past several years. Studies of the prevalence of SAD and nonseasonal mood disorders among relatives of patients with SAD suggested a familial contribution to the development of SAD. Two twin studies demonstrated a substantial role of genetic variation in seasonality. Two genetic variants related to serotonergic transmission, the 5-HTTLPR and the 5-HT_2A-1438G/A gene promoter polymorphisms, have been found to be associated with SAD. 5-HTTLPR is also associated with seasonality in SAD patients and in the general population. It is not clear whether SAD is inherited as a distinct entity or whether seasonality and depression are separate heritable traits that happen to coincide in certain individuals. Vulnerability to SAD and disease pathology may be influenced by many genes, perhaps on several chromosomes.
Low HDL cholesterol, aggression and altered central serotonergic activity
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Many studies support a significant relation between low cholesterol levels and poor impulse, aggression and mood control. Evidence exists also for a causal link between low brain serotonin (5-HT) activity and these behaviors. Mechanisms linking cholesterol and hostile or self-destructive behavior are unknown, but it has been suggested that low cholesterol influences 5-HT function. This study was designed to explore the relationship between plasma cholesterol, measures of impulsivity and aggression, and indices of 5-HT function in personality disordered cocaine addicts. Thirty-eight hospitalized male patients (age 36.8±7.1) were assessed with the DSM-III-R, the Buss–Durkee Hostility Inventory (BDHI), the Barratt Impulsiveness Scale (BIS) and the Brown–Goodwin Assessment for Life History of Aggression. Fasting basal cholesterol (total, LDL and HDL) was determined 2 weeks after cocaine discontinuation. On the same day 5-HT function was assessed by neuroendocrine (cortisol and prolactin) and psychological (NIMH and ‘high’ self-rating scales) responses following meta-chlorophenylpiperazine (m-CPP) challenges. Reduced neuroendocrine responses, ‘high’ feelings and increased ‘activation-euphoria’ following m-CPP have been interpreted as indicating 5-HT alterations in a variety of psychiatric conditions. Significantly lower levels of HDL cholesterol were found in patients who had a history of aggression (P=0.005). Lower levels of HDL cholesterol were also found to be significantly associated with more intense ‘high’ and ‘activation-euphoria’ responses as well as with blunted cortisol responses to m-CPP (P=0.033, P=0.025 and P=0.018, respectively). This study gives further support to existing evidence indicating that in some individuals, the probability of exhibiting impulsive and violent behaviors may be increased when cholesterol is low. It also suggests that low cholesterol and alterations in 5-HT activity may be causally related.

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Behavioral responses to intravenous meta-chlorophenyl- piperazine in patients with seasonal affective disorder and control subjects before and after phototherapy

Abstract

Life Sciences

Biological Psychiatry

Biological Psychiatry

Biological Psychiatry

Biological Psychiatry

Biological Psychiatry

Comprehensive Psychiatry

Psychiatry Research

Psychiatry Research

DSM-III-R: Diagnostic and Statistical Manual of Mental Disorders

Serotonin, satiety, and bulimia nervosa

Biological Psychiatry

Seasonal and circadian monoamine variations in human brains examined post-mortem

Acta Psychiatrica Scandinavica

Serotonin function in anxiety: II. Effects of the serotonin agonist m-CPP in panic disorder patients and healthy subjects

Psychopharmacology

Physiological doses of prolactin stimulate pelage pigmentation in Djungarian hamster

American Journal of Physiology

Reliability, validity and clinical application of the visual analogue mood scale

Psychological Medicine

Development of a rating scale for primary depressive illness

British Journal of Social and Clinical Psychology

Experimental development of the graphic rating method

Psychological Bulletin

Evolving concepts of sleep cycle generation: From brain centers to neuronal populations

Behavioral Brain Science

Quantification of sleepiness: A new approach

Psychophysiology

Photoperiodism in vertebrates

Possible augmentation of antidepressant response by buspirone

Journal of Clinical Psychiatry

The role of serotonin in seasonal affective disorder and phototherapy

Seasonal affective disorder

Neuroendocrine responses to 5-hydroxytryptophan in seasonal affective disorder (SAD)

Archives of General Psychiatry

Basic mechanisms of sleep-wake states

Slow wave sleep and indoleamines: A hypothalamic target