Neuroendocrine correlates of depression in abstinent heroin-dependent subjects

Psychiatry Res. 2000 Nov 20;96(3):221-34. doi: 10.1016/s0165-1781(00)00192-x.

Abstract

The functions of the central alpha-adrenergic, serotoninergic and dopaminergic systems were investigated in 28 heroin-dependent subjects 6-8 weeks after detoxification, and in 22 healthy control subjects (group C). Fourteen heroin-dependent subjects with depressive comorbidity (group A), and 14 heroin-dependent subjects without other Axis I and II pathologies (group B) were included among abstinent substance abusers. Norepinephrine (NE) function was evaluated by growth hormone (GH) responses to acute stimulation with clonidine (clon); serotonin (5-HT) function by prolactin (PRL) and cortisol (CORT) responses to acute stimulation with D-fenfluramine (D-fen) and dopamine (DA) function by GH and PRL responses to acute administration of bromocriptine (brom). Central NE activity, as measured by the GH-clon test, seems to be well preserved both in A and B subjects. PRL and CORT responses to D-fen were significantly blunted both in A subjects and in B subjects, in comparison with control subjects (C); the PRL response in A subjects was significantly lower than in B subjects. The DA system of B subjects was found unimpaired; in contrast, a significantly higher GH response to brom in A subjects (depressed) could express D2 post-synaptic receptor hypersensitivity and, therefore, decreased pre-synaptic DA release. In sum, the study of central monoamine function revealed an alteration only of the 5-HT system in detoxified heroin-dependent subjects without psychiatric comorbidity, which might be a trait character of these subjects, possibly involved in the pathogenesis of the disorder. A more significant impairment of 5-HT function and the hypersensitivity of post-synaptic DA receptors in A subjects suggests that specific biological correlates of psychiatric comorbidity may characterize substance abuser subtypes.

Publication types

  • Comparative Study

MeSH terms

  • Adrenergic alpha-Agonists / pharmacology
  • Adult
  • Analysis of Variance
  • Biomarkers
  • Brain / metabolism
  • Bromocriptine / pharmacology
  • Case-Control Studies
  • Clonidine / pharmacology
  • Depression / metabolism
  • Depressive Disorder, Major / metabolism*
  • Depressive Disorder, Major / psychology
  • Diagnosis, Dual (Psychiatry)
  • Dopamine / metabolism*
  • Dopamine Agonists / pharmacology
  • Female
  • Fenfluramine / pharmacology
  • Heroin Dependence / metabolism*
  • Heroin Dependence / psychology
  • Heroin Dependence / therapy
  • Humans
  • Male
  • Norepinephrine / metabolism*
  • Psychiatric Status Rating Scales
  • Receptors, Adrenergic / drug effects
  • Receptors, Dopamine / drug effects
  • Receptors, Serotonin / drug effects
  • Serotonin / metabolism*
  • Serotonin Agents / pharmacology
  • Substance Abuse Detection

Substances

  • Adrenergic alpha-Agonists
  • Biomarkers
  • Dopamine Agonists
  • Receptors, Adrenergic
  • Receptors, Dopamine
  • Receptors, Serotonin
  • Serotonin Agents
  • Fenfluramine
  • Serotonin
  • Bromocriptine
  • Clonidine
  • Dopamine
  • Norepinephrine