Am J Psychiatry 1993; 150:1164-1168
Copyright © 1993 by American Psychiatric Association
Anger attacks in unipolar depression, Part 2: Neuroendocrine correlates and changes following fluoxetine treatment
JF Rosenbaum, M Fava, JA Pava, MK McCarthy, RJ Steingard and E Bouffides
Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.
OBJECTIVE: Neuroendocrine derangements have been reported in both
depression and aggressive behavior. The purpose of this study was to
evaluate whether the subset of depressed patients with anger attacks have a
distinctive neuroendocrine abnormality. METHOD: The thyrotropin- releasing
hormone (TRH) test was administered to 25 patients with major depression,
12 of whom reported having anger attacks, at the Depression Research
Program of the Clinical Psychopharmacology Unit at the Massachusetts
General Hospital. Twenty-two subjects underwent the TRH test again after 8
weeks of treatment with fluoxetine, a relatively selective serotonin uptake
inhibitor. RESULTS: The depressed patients with anger attacks had a blunted
prolactin response to TRH stimulation compared to the depressed patients
without anger attacks. Treatment with fluoxetine was followed by an overall
increase in the prolactin response to TRH among the depressed patients with
anger attacks. The prolactin response to TRH also tended to predict the
degree of response to treatment. CONCLUSIONS: These results suggest that
the subset of depressed patients with anger attacks may have a greater
central serotonergic dysregulation than depressed patients without such
attacks.
