engleski

Sertraline-mediated endocrine effects in depressed patients

Depression is related to the changes in various neurotransmitter systems and in the altered activity of the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axis. The aim of the present study was to evaluate the effects of short-term (4 weeks) and long-term (24 weeks) sertraline (average dose 42.5 mg/day, PO) treatment, a potent selective serotonin reuptake inhibitor, on HPA and HPT activity in 15 female nonpsychotic, depressed patients. The effects of sertraline were evaluated at the beginning of the treatment (baseline), and after 4 and 24 weeks of sertraline treatment, using Montgomery-Asperg Depression Rating Scale (MADRS), 17-item Hamilton Depression Rating Scale (HAMD), and Clinical Global Impression Scale (CGI), on plasma concentrations of cortisol, prolactin, thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxin (T4). Significant clinical improvement in symptoms of depression was observed after long-term sertraline treatment, as indicated in the reduction in MADRS, HAMD and CGI scores. The results of the study show 47% responders after 4 and 87% responders after 24 weeks of sertraline treatment, a short-term sertraline treatment-induced increase of plasma cortisol, and a long-term treatment-induced rise of plasma T3 concentration, with no correlation between MADRS scores and particular hormons. Neither short-, nor long-term sertraline treatment affected plasma levels of PRL, T4 and TSH. Our data show antidepressant effects of sertraline in the treatment of major depression and suggest different and time dependent effect of sertraline on the activity of the HPA and HPT axis in female depressed patients.

sertraline; plasma cortisol; prolactin and thyroid hormones

DOI: 10.1046/j.1472-8206.2001.00064.x