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October 1990

Memory Improvement in Korsakoff's Disease With Fluvoxamine-Reply

Author Affiliations

Division of Alcohol and Substance Abuse Departments of Psychiatry and Pharmacology Vanderbilt University School of Medicine Nashville, TN 37232
Department of Psychiatry Medical University of South Carolina and Veterans Administration Medical Center Charleston, SC 29403
Laboratory of Clinical Studies Division of Intramural Clinical and Biological Research National Institute on Alcohol Abuse and Alcoholism Bethesda, MD 20892
Intramural Research Program National Institute of Mental Health Bethesda, MD 20892

Arch Gen Psychiatry. 1990;47(10):978-979. doi:10.1001/archpsyc.1990.01810220094016

In Reply.—  The comments of Drs McEntee and Mair raise a number of issues worthy of discussion. However, their underlying concern seems to be whether it is appropriate to conclude that an improvement of memory during treatment with fluvoxamine maleate in patients with Korsakoff's psychosis (KP) suggests an etiologic role of serotonergic mechanisms in alcoholic organic brain disease. They indicate that "more direct data," eg, diminished pretreatment levels of cerebrospinal fluid (CSF) 5-hydroxyin-doleacetic acid (5-HIAA) or improvement of memory test performance by treatment with selective serotonin agonists, would be required to substantiate the hypothesis of underlying serotonergic dysfunction in KP.Although the assessment in vivo of central serotonergic function is of considerable interest in understanding a wide range of psychiatric abnormalities,1,2 it is uncertain whether CSF levels of 5-HIAA actually provide a measure of functionally active serotonin in periventricular brain regions.3 Therefore, the absence of a significant correlation between