Effects of mirtazapine on dehydroepiandrosterone-sulfate and cortisol plasma concentrations in depressed patients

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• 作者：Cornelius Schü ; le ; Thomas C. Baghai ; Daniela Eser ; Markus Schwarz ; Brigitta Bondy ; Rainer Rupprecht
• 关键词：Mirtazapine ; Cortisol ; Dehydroepiandrosterone ; Major depression
• 刊名：Journal of Psychiatric Research
• 出版年：2009
• 出版时间：February 2009
• 年：2009
• 卷：43
• 期：5
• 页码：538-545
• 全文大小：322 K

文摘

Background

Among the neuroactive steroids, dehydroepiandrosterone sulfate (DHEA-S) is at least in part produced in the adrenal gland and is therefore under the control of the hypothalamic–pituitary–adrenocortical (HPA)-system. In the present study, the impact of mirtazapine on DHEA-S and cortisol (COR) levels was investigated in relation to clinical response in depressed patients.

Methods

A total of 23 inpatients suffering from a major depressive episode (DSM-IV criteria) underwent 5-week treatment with mirtazapine (45 mg/day). Plasma samples were taken weekly at 0800 h and quantified for COR and DHEA-S levels.

Results

Mirtazapine significantly reduced both COR and DHEA-S concentrations, but had no impact on the COR/DHEA-S ratio. The percentage decrease of DHEA-S, but not that of COR was significantly and positively correlated with the percentage reduction in the sum score of the Hamilton Depression Rating Scale at week 5, suggesting a relationship between DHEA-S reduction and clinical efficacy of mirtazapine. There was a significant positive correlation between the decline in COR and DHEA-S levels.

Conclusions

Apparently, the decrease in COR and DHEA-S concentrations conjointly reflects an attenuating impact of mirtazapine on HPA axis activity, thereby decreasing the adrenal secretion of COR and DHEA-S.