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April 1989

Blockade of the Postictal Prolactin Surge by Methysergide

Author Affiliations

Department of Psychiatry University of British Columbia 2211 Wesbrook Mall Vancouver, BC Canada V6T 2A1
Department of Neurosciences McMaster University 1200 Main St Hamilton, Ontario Canada L8N 3Z5

Arch Gen Psychiatry. 1989;46(4):385-387. doi:10.1001/archpsyc.1989.01810040091019

To the Editor.—  Plasma prolactin (PRL) levels increase severalfold immediately following tonic-clonic seizures, complex partial seizures, and electroconvulsive therapy (ECT).1-5 Depth electroencephalographic recordings suggest that spreading of the ictal discharge to subcortical (limbic) structures is necessary for the observed PRL release.6 The neurochemical substrate of this neuroendocrine response, however, remains unknown. We report here that pretreatment with the classic serotonin receptor antagonist methysergide blocks the ECTinduced PRL surge.

Patients and Methods.—  Eight drug-free patients receiving a course of unilateral (n = 5) or bilateral (n = 3) ECT as the clinically indicated treatment for their illness were the subjects of our study. The doses of thiopental sodium and succinylcholine chloride and the voltage and duration of the electrical stimulus were individually adjusted for each patient during the first two treatments and remained constant for treatments 3 through 5. Seizure duration was monitored by the pressure cuff method and averaged