The effect of m-CPP on tics and obsessive-compulsive phenomena in Gilles de la Tourette syndrome |
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Authors: | D. C. Cath Harm J. Gijsman Rik C. Schoemaker Jean M. T. van Griensven Nancy Troost Godfried M. J. van Kempen Adam F. Cohen |
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Affiliation: | (1) Psychiatric Hospital Amsterdam Outpatient Clinic, 2de Constantijn Huygensstraat 37, 1054 AG Amsterdam, The Netherlands e-mail: ingel@xs4all.nl, Fax: +31-20-5895116, NL;(2) Department of Psychiatry, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands, NL;(3) Endegeest Psychiatric Hospital, Oegstgeest, The Netherlands, NL;(4) Centre for Human Drug Research, Zernikedreef 10, 2333 CL Leiden, The Netherlands, NL |
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Abstract: | Rationale: Family genetic and phenomenological studies support an interrelationship between Gilles de la Tourette syndrome (GTS) and obsessive-compulsive disorder (OCD). Some authors consider GTS as part of a serotonergically mediated cluster of OCD spectrum disorders. Objective: To study serotonergic mechanisms in GTS, the effect of the relatively selective 5-HT2c agonist meta-chlorophenylpiperazine (m-CPP) was assessed. Methods: We studied the behavioural effects of m-CPP on tics, obsessions, compulsions and impulsions of GTS. Twelve medication-free GTS patients (ten men, two women) were included in a single dose 0.5 mg/kg oral m-CPP challenge study with a double-blinded placebo-controlled cross-over design. Global symptom scores, target symptom scores as well as biochemical measures were followed up to 24 h after baseline. Results: While m-CPP caused a significant rise in plasma cortisol and prolactin levels, no significant effects were found on the tics, obsessions and compulsions. Impulsions showed a trend to ameliorate. Conclusions: This study does not support a predominant role for 5-HT on the tics in GTS. The trend of impulsions to ameliorate after m-CPP can be interpreted as circumstantial support for impulsivity-related 5-HT hypofunctionality in GTS. However, the large variability of m-CPP plasma concentrations found in this study casts doubts upon the reliability of m-CPP as a probe for challenge studies. Received: 31 July 1998 / Final version: 6 November 1998 |
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Keywords: | Gilles de la Tourette syndrome Meta-chlorophenylpiperazine Obsessive-compulsive disorder Impulsions Serotonin |
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