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Titolo:
Reduction in basal afternoon plasma ACTH during early treatment of depression with fluoxetine
Autore:
Inder, WJ; Prickett, TCR; Mulder, RT; Donald, RA; Joyce, PR;
Indirizzi:
Christchurch Sch Med, Christchurch, New Zealand Christchurch Sch Med Christchurch New Zealand Christchurch, New Zealand Christchurch Hosp, Dept Med Psychol, Christchurch, New Zealand Christchurch Hosp Christchurch New Zealand l, Christchurch, New Zealand Christchurch Hosp, Dept Endocrinol, Christchurch, New Zealand ChristchurchHosp Christchurch New Zealand l, Christchurch, New Zealand
Titolo Testata:
PSYCHOPHARMACOLOGY
fascicolo: 1, volume: 156, anno: 2001,
pagine: 73 - 78
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORTICOTROPIN-RELEASING HORMONE; PITUITARY-ADRENAL AXIS; RECEPTOR GENE-EXPRESSION; ARGININE-VASOPRESSIN; ENDOGENOUS-DEPRESSION; CORTISOL SECRETION; THERAPEUTIC IMPLICATIONS; ANTIDEPRESSANT DRUGS; TYROSINE-HYDROXYLASE; MAJOR DEPRESSION;
Keywords:
nortriptyline; fluoxetine; cortisol; corticotropin; arginine vasopressin; depression;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Inder, WJ Univ Melbourne, St Vincents Hosp, Dept Med, Corner Princes & Regent St, Fitzroy, Vic 3065, Australia Univ Melbourne Corner Princes & RegentSt Fitzroy Vic Australia 3065
Citazione:
W.J. Inder et al., "Reduction in basal afternoon plasma ACTH during early treatment of depression with fluoxetine", PSYCHOPHAR, 156(1), 2001, pp. 73-78

Abstract

Rationale: Subjects with depression may exhibit activation of the hypothalamic-pituitary-adrenal (HPA) axis, but little is known about the response of basal hormone levels to antidepressant therapy. Objectives: To determine whether treatment of depression with standard antidepressant medications resulted in reductions in basal activity of afternoon cortisol, ACTH and AVP. A secondary aim was to examine whether there was any difference in hormonal response between an SSRI (fluoxetine) and a tricyclic antidepressant (nortriptyline). Methods: Forty-three subjects with a DSM-IV diagnosis of depression (Hamilton score 18.9 +/-0.6 at baseline) had five basal venous blood samples drawn at 15-min intervals between 1400 and 1500 hours for cortisol,ACTH and AVP, before and 6 weeks after randomisation to treatment with fluoxetine (n=27) or nortriptyline (n=16). Results: Both medications resulted in a similar improvement in depression as determined by Hamilton score. In the group as a whole, ACTH levels showed a significant decrease over the 6 weeks (4.1 +/-0.4 pmol/l at baseline versus 3.3 +/-0.3 at 6 weeks, P <0.05), while cortisol and AVP levels were unchanged. Further analysis revealed that the fall in plasma ACTH occurred predominantly in the subgroup treated with fluoxetine (drug x time interaction by ANOVA, P=0.035). There was a significant relationship between cortisol and ACTH at baseline (r=0.48, P=0.002), that weakened considerably after treatment (r=0.22, P=0.16). The subgroup with baseline hypercortisolemia [mean cortisol > 276 nmol/l (10 mug/dl), n=18] demonstrated a reduction in both cortisol and ACTH following treatment, but also showed a loss of the relationship between the two. Conclusions: It is postulated that the initial recovery of the HPA axis during the treatment of depression with fluoxetine is mediated via restoration of glucocorticoid negative feedback on ACTH levels.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 04:08:07