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Specific effects of escitalopram on neuroendocrine response.

Author(s): Hawken ER, Owen JA, Hudson RW, Delva NJ

Affiliation(s): Providence Care Centre-Mental Health Services, Kingston, ON, Canada.

Publication date & source: 2009-11, Psychopharmacology (Berl)., 207(1):27-34. Epub 2009 Aug 7.

Publication type: Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

PURPOSE: Citalopram, a selective serotonin reuptake inhibitor, is used as a neuroendocrine probe in human subjects to assess serotonin function as reflected in prolactin and plasma cortisol release. Citalopram is a racemic mixture of equal proportions of the S(+) and R(-) enantiomers. Inhibition of serotonin reuptake and, consequently, antidepressant activity is associated, almost exclusively, with the S(+) enantiomer ("escitalopram"). Studies in animal models indicate that the presence of the R(-) isomer may interfere with the serotonin reuptake activity of escitalopram. The current study compared the neuroendocrine effects of citalopram and escitalopram in healthy human volunteers. METHODS: Plasma cortisol and prolactin levels following a single oral dose of citalopram (40 mg) or escitalopram (20 mg) were compared in samples taken every 15-30 min over a period of 240 min. Plasma citalopram concentration was determined at the same intervals. RESULTS: Escitalopram and citalopram caused equivalent increases in plasma cortisol and prolactin. The administration of dexamethasone prior to the escitalopram challenge blocked the evoked increase in cortisol. CONCLUSION: This is the first study to prove that a single dose of escitalopram acts centrally and not peripherally, providing further support of the use of oral escitalopram as a probe for brain serotonergic function.

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