Volume : 7, Issue : 7, July - 2018

PROLACTIN LEVELS BEFORE AND AFTER ELECTROCONVULSIVE THERAPY AND ITS CORELATION WITH CLINICAL IMPROVEMENT IN PSYCHOPATHALOGY

Dr. Shalini Bijali, Dr D. Ram, Dr. S. K. Munda, Dr. Vikalp Wasnik

Abstract :

<div style="mso-element:para-border-div;border:none black 1.0pt;mso-border-alt:&#10;none black 0in;padding:0in 0in 0in 0in"> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">BACKGROUND:</span></u></b><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;"> It is a well-known fact that prolactin increases after Electroconvulsive Therapy (ECT), but in later studies it was found that the amount of prolactin rise after each ECT gradually declines on successive ECT. Many studies have found that there is a correlation between this prolactin drop and improvement in psychopathology. But the results found were inconsistent and only limited to depression.</span></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">AIM:</span></u></b><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="mso-bidi-font-family:&quot;Times New Roman&quot;"><span style="mso-spacerun:yes">&nbsp; </span></span></b><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">To see the serum prolactin changes during a course of ECT in patients suffering from BPAD mania and to assess whether any correlation exists between these changes and improvement in psychopathology.</span></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">METHORD:</span></u></b><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;"> 20 inpatients meeting diagnostic criteria for BPAD mania as per ICD-10 who were planned to receive ECT were taken as cases and 20 BPAD mania patients not receiving ECT were taken as controls. Blood for prolactin and psychopathology on YMRS assessed three times in each case. First at baseline, second after 1</span><span lang="EN-IN" style="font-size:8.0pt;&#10;mso-bidi-font-size:12.0pt;line-height:150%;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;position:relative;top:-12.0pt;mso-text-raise:12.0pt">st</span><span lang="EN-IN" style="mso-bidi-font-family:&quot;Times New Roman&quot;"><span style="mso-spacerun:yes">&nbsp;</span>ECT and third after last ECT. Similarly controls were assessed at baseline and after three weeks for prolactin and psychopathology.</span></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">RESULTS:</span></u></b><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;"> In patients who received ECT, serum prolactin levels were significantly raised after 1</span><span lang="EN-IN" style="font-size:8.0pt;&#10;mso-bidi-font-size:12.0pt;line-height:150%;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;position:relative;top:-12.0pt;mso-text-raise:12.0pt">st</span><span lang="EN-IN" style="mso-bidi-font-family:&quot;Times New Roman&quot;"><span style="mso-spacerun:yes">&nbsp;</span>ECT (mean 78.65) compared to baseline (mean 54.02). Prolactin level significantly decreased after a course of ECT (mean 67.22). There was no significant correlation between prolactin changes and in YMRS score.</span></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">CONCLUSION:</span></u></b><span lang="EN-IN" style="mso-bidi-font-family:&#10;&quot;Times New Roman&quot;"> There is no significant correlation between prolactin changes during a course of ECT and improvement in psychopathology in BPAD mania patients suggesting the prolactin rise may be an epiphenomenon to ECT rather than reflection of therapeutic process.</span></p> </div>