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Neuroendocrine, appetitive and behavioural responses to d-fenfluramine in women recovered from anorexia nervosa

Published online by Cambridge University Press:  03 January 2018

Anne Ward ,
Nigel Brown ,
Stafford Lightman ,
Iain C. Campbell  and
Janet Treasure
Anne Ward*
Affiliation:
Institute of Psychiatry, King's College, London
Nigel Brown
Affiliation:
Institute of Psychiatry, King's College, London
Stafford Lightman
Affiliation:
Department of Medicine, Bristol Royal Infirmary, Bristol
Iain C. Campbell
Affiliation:
Institute of Psychiatry, King's College, London
Janet Treasure
Affiliation:
Institute of Psychiatry, King's College, London
*
Dr Iain Campbell, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
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Abstract

Background

Increased central serotonin (5-HT) function has been hypothesised to be a vulnerability trait in anorexia nervosa.

Methods

Eighteen women with a history of DSM–III–R anorexia nervosa and 18 female controls were examined. The subjects had recovered weight and menstrual function. A placebo-controlled d-fenfluramine test was used. Subjects ingested d-fenfluramine or placebo and after three hours were offered a ‘free’ meal. The amounts eaten were recorded and plasma Cortisol and prolactin levels were measured. Questionnaires related to eating attitudes and behaviour, to personality, and to mood were administered.

Results

Unlike the control subjects, those recovered from anorexia nervosa did not show the expected appetite-suppressing responses to d-fenfluramine; their eating attitudes and behaviour were more restrained, ‘negative’ perfectionism was more pronounced, and post-meal plasma Cortisol levels did not rise as expected.

Conclusions

Our results do not suggest that increased central 5-HT function is a trait marker in anorexia nervosa, but dysregulation in part of the central 5-HT system may be a vulnerability factor. The flattened post-meal response to Cortisol in the subjects who had recovered from anorexia nervosa suggests that their hypothalamic–pituitary–adrenal axis may be altered and deserves further investigation.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 4 , April 1998 , pp. 351 - 358
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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