Delayed obsessive-compulsive disorder symptom exacerbation after a single dose of a serotonin antagonist in fluoxetine-treated but not untreated patients. Academic Article uri icon

Overview

MeSH

  • Adult
  • Behavior
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Time Factors

MeSH Major

  • Fluoxetine
  • Metergoline
  • Obsessive-Compulsive Disorder
  • Serotonin Antagonists
  • Serotonin Uptake Inhibitors

abstract

  • Enhanced serotonergic transmission may underlie therapeutic effects of serotonin reuptake inhibitors in obsessive-compulsive disorder. However, such treatment may decrease serotonin receptor responsivity. We investigated whether the serotonin antagonist metergoline would exacerbate or further improve systems in fluoxetine-responsive patients. Pilot results suggested open metergoline produced delayed symptom worsening in fluoxetine-treated patients. Fourteen patients continuing fluoxetine received metergoline and placebo (double-blind, randomized). Symptom ratings continued for 1 week afterwards. Ten unmedicated patients underwent the same procedures. Symptoms improved 4 h after both metergoline and placebo. The day after metergoline but not placebo, fluoxetine-treated patients had significantly increased anxiety, obsessions and compulsions, abating over several days. Depression was unchanged. Metergoline had no similar delayed effects in unmedicated patients. Metergoline levels were higher in fluoxetine-treated patients. These results, consistent with less conclusive earlier findings, suggest that prolonged changes in brain serotonin function underlie symptom re-emergence following administration of metergoline to fluoxetine-treated patients with obsessive-compulsive disorder.

publication date

  • December 1998

has subject area

  • Adult
  • Behavior
  • Double-Blind Method
  • Female
  • Fluoxetine
  • Humans
  • Male
  • Metergoline
  • Middle Aged
  • Obsessive-Compulsive Disorder
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Serotonin Antagonists
  • Serotonin Uptake Inhibitors
  • Time Factors

Research

keywords

  • Clinical Trial
  • Journal Article
  • Randomized Controlled Trial

Identity

Language

  • eng

PubMed ID

  • 9888619

Additional Document Info

start page

  • 434

end page

  • 444

volume

  • 140

number

  • 4