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(Stroke. 1998;29:1293-1298.)
© 1998 American Heart Association, Inc.

Original Contributions

Diminished Serotonin-Mediated Prolactin Responses in Nondepressed Stroke Patients Compared With Healthy Normal Subjects

Rajamannar Ramasubbu, MD, MRCPsych, FRCPC; Alastair Flint, MB, FRCPC, FRANZCP; Gregory Brown, MD, PhD, FRCPC; George Awad, MD, FRCPC; Sidney Kennedy, MD, MRCPsych, FRCPC

From the Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital (R.R.), Ottawa, Canada; the Department of Psychiatry, University of Toronto, the Queen Elizabeth Hospital and the Toronto Hospital (A.F.); and the Clarke Institute of Psychiatry, University of Toronto (G.B., G.A., S.K.), Toronto, Canada.

Correspondence and reprint requests to Dr Ramasubbu, Royal Ottawa Hospital, 1145 Carling Avenue, Ontario, K1Z 7K4, Canada.

Background and Purpose—The purpose of this study was to use hormonal responsiveness to d-fenfluramine (d-FEN) challenge as a measure of central serotonin (5-HT) function in a comparative evaluation of serotonergic abnormalities between stroke patients and healthy elderly normal subjects to test the hypothesis that stroke may be associated with diminished serotonergic functioning.

Methods—Eight nondepressed medically stable stroke patients and 12 healthy volunteers completed a single-blind, placebo-controlled, fixed-order, crossover design challenge test with 30 mg of oral d-FEN. Baseline prolactin (PRL) and cortisol (CORT) and hormonal responses to d-FEN and placebo were measured at hourly intervals over a 4-hour period. Cardiovascular responses (pulse and blood pressure) and behavioral responses were also recorded at the same time points.

Results—The 2 groups were comparable in demographics, body weight, plasma drug concentration, and behavioral and CORT responses. A 3-way ANOVA for repeated measures showed group differences for baseline adjusted PRL responses (change of scores from baseline). Peak PRL responses (maximal PRL change from baseline scores after treatment with d-FEN) in nondepressed stroke patients were attenuated compared with healthy elderly subjects, suggesting diminished serotonergic responsiveness in stroke patients.

Conclusions—The demonstrated serotonergic hypofunctioning poststroke may contribute to the high incidence of depressive disorders in stroke patients. Serotonergic agents may have a role in augmentation of stroke recovery.

Key Words: hormones • serotonin • stroke

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