Effects of clonidine on blood pressure, noradrenaline, cortisol, growth hormone, and prolactin plasma levels in high and low intestinal tone subjects.

Systolic blood pressure (SBP), diastolic blood pressure (DBP), norepinephrine (NE), cortisol (CRT), growth hormone (GH), and prolactin (PRL) plasma levels were investigated in 46 normal subjects, 28 high intestinal tone (high IT) and 18 low intestinal tone (low IT), before and after the administration of a single intramuscular dose of clonidine (2.5 micrograms/kg). High IT subjects had lower mean values of DBP than low IT subjects, and basal NE was significantly greater in low IT than in high IT subjects. A negative correlation between NE and IT values was found for the high IT, but not for the low IT group, during the preclonidine periods. The drug reduced SBP in high IT, whereas it reduced SBP plus DBP and NE in low IT subjects. Clonidine induced significant reductions of CRT and increases of GH in both groups; furthermore, a slight but significant reduction of PRL was registered in high IT group. The drug also induced increase of distal colon tone in high IT subjects and suppressed phasic activity (waves) in low IT subjects. While a significant positive correlation was found between NE and DBP in low IT subjects during postclonidine periods, no correlation was found between the two parameters in high IT subjects. Other significant positive (+) and negative (-) correlations during postclonidine periods were: CRT/GH (-), CRT/PRL (+), and GH/PRL (-) in high IT subjects; NE/CRT (+), NE/GH (-), CRT/GH (-), CRT/DBP (+), and GH/DBP (-) in low IT subjects. Finally, significant negative correlation was found between NE and distal colon tone during postclonidine periods in high IT subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Distal colon motility and clinical parameters in depression.

Eighty-six patients suffering from nonpsychotic unipolar major depressive disorder, according to Research Diagnostic Criteria, were rated on a modified Hamilton Rating Scale for Depression (HRS). All completed the self-rating Beck Depression Inventory (BDI). Distal colon motility (dcm) studies, performed in all the patients, differentiated two types: low intestinal tone (low-IT) = 40 subjects, and high intestinal tone (high-IT) = 46 subjects. Low-IT depressed patients showed a statistically significant preponderance in the HRS items 'retardation', 'somatization', 'fatigability', 'hypochondriasis' and 'obsessional symptoms'. The high-IT depressed patients, on the other hand, showed preponderance in the items 'guilt', 'suicide', 'insomnia', 'agitation', 'anxiety psychic', 'loss of insight', 'depersonalization' and 'paranoid symptoms'. A positive correlation (r) was found between HRS- and BDI-mean total scores. In addition, a positive correlation (r) was found between HRS scores and distal colon tone in high-IT patients, although the same was not true for low-IT patients. Our results suggest the existence of two subtypes of depressive syndromes, distinguishable on the basis of distal colon motility profiles.

Distal colon motility as a predictor of antidepressant response to fenfluramine, imipramine and clomipramine.

The present study gathers results obtained in the treatment of 86 depressed outpatients. The patients were grouped according to their distal colon tone, low-IT and high-IT. All the patients fulfilled the Research Diagnostic Criteria for nonpsychotic unipolar major depressive disorder and were rated on a slightly modified 18-item Hamilton Rating Scale for Depression (HRS). They also completed the 21-item self-rating Beck Depression Inventory (BDI). The 46 subjects from the high-IT group and the 40 subjects from the low-IT group were divided into three subgroups each for double-blind trials performed with clomipramine (CMI), imipramine (IMI), and fenfluramine (FENF). Normalization of HRS and BDI scores and reduction of IT were obtained with IMI and FENF but not CMI in high-IT patients; whereas normalization of both scores and increase in IT were obtained with CMI but not with IMI or FENF in low-IT patients. FENF was not tolerated in this last group. HRS and BDI scores correlated well during in-treatment periods. Our results suggest that distal colon tone is a guide to determining the pharmacotherapy in the depressive disorders. Furthermore, it was shown that FENF is a useful anti-depressant drug in one type of patient.

Distal colon motility in schizophrenic patients.

Although the dopaminergic blocking agents (DBA) haloperidol and sulpiride strongly inhibit distal colon motility in most nonpsychotic subjects (83 per cent), this effect was registered in only 10 per cent of the 30 schizophrenic patients investigated in the present study. In these cases, only sulpiride (an "atypical" DBA) displayed distal colon motility inhibition in schizophrenic subjects. When haloperidol (a "classical" DBA) produced any modification (in 23.3 per cent), this was rather in the nature of an increase in motility. All these cases showed low or absent distal colon motility during preinjection periods. the fact that three different types of antinoradrenergic drugs (dihydroergotamine, phentolamine, and clonidine), but not DBA, inhibited distal colon motility in 90 per cent of the schizophrenic subjects suggests the existence of an overactivity of the noradrenergic system at this peripheral level.