The response to sulpiride in major depression before and after cognitive behavioural therapy: D2 receptor function

Authors: Bell, Caroline; Bhika, Shamina; Porter, Richard; Frampton, Chris; Carter, Janet; McIntosh, Virginia; Jordan, Jenny; Joyce, Peter

Source: Acta Neuropsychiatrica, Volume 20, Number 4, August 2008 , pp. 199-206(8)

Publisher: Wiley-Blackwell

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Abstract:

Bell C, Bhika S, Porter R, Frampton C, Carter J, McIntosh V, Jordan J, Joyce P. The response to sulpiride in major depression before and after cognitive behavioural therapy: D2 receptor function. Background:

Previous studies have suggested that antidepressant treatment of depression may potentiate dopamine transmission through increased sensitivity of postsynaptic D2 receptors. Method:

D2 receptor function was assessed in 24 patients with major depression before and 16 patients after 16 weeks of treatment with cognitive behavioural therapy (CBT) using a challenge with a selective D2 antagonist, sulpiride. Four hundred milligrams of sulpiride was administered orally on two test days and response was measured by the change in prolactin levels and changes in self-rating scale measures of mood, anxiety and pleasure. Results:

The prolactin response to sulpiride (as measured by the maximum prolactin level) was significantly increased after CBT (z=−2.792, p= 0.005). Sulpiride resulted in an improvement on mood ratings on both test days, but after CBT, this effect was significantly diminished as measured by the Profile of Mood States score (t=−2.27, p= 0.038). Conclusions:

After 16 weeks of CBT, we detected an enhanced prolactin response to sulpiride, suggesting an increased sensitivity of D2 receptor functioning.

Keywords: cognitive behavioural therapy; depression; dopamine; sulpiride

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1601-5215.2008.00284.x

Affiliations: 1: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand

Publication date: 2008-08-01