Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects
OBJECTIVE: This study was done to compare the effects of 6-week treatment with amitriptyline on hypothalamic-pituitary-adrenocortical (HPA) regulation in elderly depressed patients and age-matched comparison subjects. METHOD: A combined dexamethasone-suppression/CRH- stimulation (dexamethasone/CRH)...
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| Veröffentlicht in: | The American journal of psychiatry 1996-01, Vol.153 (1), p.93-99 |
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| creator | HEUSER, I. J. E SCHWEIGER, U GOTTHARDT, U SCHMIDER, J LAMMERS, C.-H DETTLING, M YASSOURIDIS, A HOLSBOER, F |
| description | OBJECTIVE: This study was done to compare the effects of 6-week
treatment with amitriptyline on hypothalamic-pituitary-adrenocortical (HPA)
regulation in elderly depressed patients and age-matched comparison
subjects. METHOD: A combined dexamethasone-suppression/CRH- stimulation
(dexamethasone/CRH) test was administered before initiation of
amitriptyline treatment and at the end of weeks 1, 3, and 6 of treatment.
Thirty-nine depressed inpatients, mean age = 69 years, completed the study.
Fourteen normal volunteers, mean age = 67 years, served as comparison
subjects. RESULTS: In relation to the comparison subjects, the depressed
patients had a profoundly abnormal HPA response, in particular an
exaggerated cortisol release in the dexamethasone/CRH test. This
abnormality began to disappear after 1 week of treatment with
amitriptyline. In contrast, amitriptyline did not affect neuroendocrine
regulation in the comparison subjects at any time during the test period.
CONCLUSIONS: The data suggest that amitriptyline affects HPA regulation in
hypercortisolemic depression only, and they raise the possibility that
normalization of its feedback control is related to the antidepressive
effect of amitriptyline. |
| doi_str_mv | 10.1176/ajp.153.1.93 |
| format | Article |
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treatment with amitriptyline on hypothalamic-pituitary-adrenocortical (HPA)
regulation in elderly depressed patients and age-matched comparison
subjects. METHOD: A combined dexamethasone-suppression/CRH- stimulation
(dexamethasone/CRH) test was administered before initiation of
amitriptyline treatment and at the end of weeks 1, 3, and 6 of treatment.
Thirty-nine depressed inpatients, mean age = 69 years, completed the study.
Fourteen normal volunteers, mean age = 67 years, served as comparison
subjects. RESULTS: In relation to the comparison subjects, the depressed
patients had a profoundly abnormal HPA response, in particular an
exaggerated cortisol release in the dexamethasone/CRH test. This
abnormality began to disappear after 1 week of treatment with
amitriptyline. In contrast, amitriptyline did not affect neuroendocrine
regulation in the comparison subjects at any time during the test period.
CONCLUSIONS: The data suggest that amitriptyline affects HPA regulation in
hypercortisolemic depression only, and they raise the possibility that
normalization of its feedback control is related to the antidepressive
effect of amitriptyline.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.153.1.93</identifier><identifier>PMID: 8540599</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>Adrenal glands ; Aged ; Amitriptyline - pharmacology ; Amitriptyline - therapeutic use ; Biological and medical sciences ; Corticotropin-Releasing Hormone ; Depressive Disorder - blood ; Depressive Disorder - drug therapy ; Depressive Disorder - physiopathology ; Dexamethasone ; Drug therapy ; Feedback - drug effects ; Feedback - physiology ; Female ; Hospitalization ; Humans ; Hydrocortisone - blood ; Male ; Medical sciences ; Mental depression ; Neuropharmacology ; Older people ; Pharmacology. Drug treatments ; Pituitary gland ; Pituitary-Adrenal System - drug effects ; Pituitary-Adrenal System - physiopathology ; Psychiatric Status Rating Scales ; Psychiatry ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Severity of Illness Index ; Treatment Outcome</subject><ispartof>The American journal of psychiatry, 1996-01, Vol.153 (1), p.93-99</ispartof><rights>1996 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Jan 1996</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a470t-83e91273f2522ccb4904219fa5ec4e00714a15e1a5c10d505cba506b5b01c6af3</citedby><cites>FETCH-LOGICAL-a470t-83e91273f2522ccb4904219fa5ec4e00714a15e1a5c10d505cba506b5b01c6af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.153.1.93$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.153.1.93$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,2859,4024,21629,27869,27923,27924,27925,77791,77792</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3013861$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8540599$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HEUSER, I. J. E</creatorcontrib><creatorcontrib>SCHWEIGER, U</creatorcontrib><creatorcontrib>GOTTHARDT, U</creatorcontrib><creatorcontrib>SCHMIDER, J</creatorcontrib><creatorcontrib>LAMMERS, C.-H</creatorcontrib><creatorcontrib>DETTLING, M</creatorcontrib><creatorcontrib>YASSOURIDIS, A</creatorcontrib><creatorcontrib>HOLSBOER, F</creatorcontrib><title>Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>OBJECTIVE: This study was done to compare the effects of 6-week
treatment with amitriptyline on hypothalamic-pituitary-adrenocortical (HPA)
regulation in elderly depressed patients and age-matched comparison
subjects. METHOD: A combined dexamethasone-suppression/CRH- stimulation
(dexamethasone/CRH) test was administered before initiation of
amitriptyline treatment and at the end of weeks 1, 3, and 6 of treatment.
Thirty-nine depressed inpatients, mean age = 69 years, completed the study.
Fourteen normal volunteers, mean age = 67 years, served as comparison
subjects. RESULTS: In relation to the comparison subjects, the depressed
patients had a profoundly abnormal HPA response, in particular an
exaggerated cortisol release in the dexamethasone/CRH test. This
abnormality began to disappear after 1 week of treatment with
amitriptyline. In contrast, amitriptyline did not affect neuroendocrine
regulation in the comparison subjects at any time during the test period.
CONCLUSIONS: The data suggest that amitriptyline affects HPA regulation in
hypercortisolemic depression only, and they raise the possibility that
normalization of its feedback control is related to the antidepressive
effect of amitriptyline.</description><subject>Adrenal glands</subject><subject>Aged</subject><subject>Amitriptyline - pharmacology</subject><subject>Amitriptyline - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Corticotropin-Releasing Hormone</subject><subject>Depressive Disorder - blood</subject><subject>Depressive Disorder - drug therapy</subject><subject>Depressive Disorder - physiopathology</subject><subject>Dexamethasone</subject><subject>Drug therapy</subject><subject>Feedback - drug effects</subject><subject>Feedback - physiology</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Neuropharmacology</subject><subject>Older people</subject><subject>Pharmacology. Drug treatments</subject><subject>Pituitary gland</subject><subject>Pituitary-Adrenal System - drug effects</subject><subject>Pituitary-Adrenal System - physiopathology</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychiatry</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><recordid>eNp1kc2L1TAUxYMo43N051YoKoJgn_lo2mYpg18woAsFd-U2vX2TR5rEJF307_AfNvoeg4iuknB-OfdyDiGPGd0z1rWv4Rj2TIo92ytxh-zKVdYd5_1dsqOU8lpJ8e0-eZDSsTyp6PgFuehlQ6VSO_Ljs8mryRC3GqaIDmydtpRxqSIeVgvZeFeBm6qQNn3jA-Qbb_1hq6Y1GneoYDE5mpA3axxWOSLkBV2ujKvQThhtITFETAmLR7ErYvpt6HxcwFbaLwGiSWVMWscj6pweknsz2ISPzucl-fru7ZerD_X1p_cfr95c19B0NNe9QMV4J2YuOdd6bBRtOFMzSNQNUtqxBphEBlIzOkkq9QiStqMcKdMtzOKSvDj5hui_r5jysJik0Vpw6Nc0dJ0qAYu-gE__Ao9-jSWrNHBOm7ZRghfo2f8gJlkvGt7xtlCvTpSOPqWI8xCiWUr8A6PDrzqHUmf5IAY2KFHwJ2fTdVxwuoXP_RX9-VmHpMHOEZw26RYTlIm-ZQV7ecIgBPPHXv8a-RNfELid</recordid><startdate>19960101</startdate><enddate>19960101</enddate><creator>HEUSER, I. J. E</creator><creator>SCHWEIGER, U</creator><creator>GOTTHARDT, U</creator><creator>SCHMIDER, J</creator><creator>LAMMERS, C.-H</creator><creator>DETTLING, M</creator><creator>YASSOURIDIS, A</creator><creator>HOLSBOER, F</creator><general>American Psychiatric Publishing</general><general>American Psychiatric Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>HAWNG</scope><scope>HBMBR</scope><scope>IBDFT</scope><scope>K30</scope><scope>PAAUG</scope><scope>PAWHS</scope><scope>PAWZZ</scope><scope>PAXOH</scope><scope>PBHAV</scope><scope>PBQSW</scope><scope>PBYQZ</scope><scope>PCIWU</scope><scope>PCMID</scope><scope>PCZJX</scope><scope>PDGRG</scope><scope>PDWWI</scope><scope>PETMR</scope><scope>PFVGT</scope><scope>PGXDX</scope><scope>PIHIL</scope><scope>PISVA</scope><scope>PJCTQ</scope><scope>PJTMS</scope><scope>PLCHJ</scope><scope>PMHAD</scope><scope>PNQDJ</scope><scope>POUND</scope><scope>PPLAD</scope><scope>PQAPC</scope><scope>PQCAN</scope><scope>PQCMW</scope><scope>PQEME</scope><scope>PQHKH</scope><scope>PQMID</scope><scope>PQNCT</scope><scope>PQNET</scope><scope>PQSCT</scope><scope>PQSET</scope><scope>PSVJG</scope><scope>PVMQY</scope><scope>PZGFC</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>19960101</creationdate><title>Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects</title><author>HEUSER, I. J. E ; SCHWEIGER, U ; GOTTHARDT, U ; SCHMIDER, J ; LAMMERS, C.-H ; DETTLING, M ; YASSOURIDIS, A ; HOLSBOER, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a470t-83e91273f2522ccb4904219fa5ec4e00714a15e1a5c10d505cba506b5b01c6af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adrenal glands</topic><topic>Aged</topic><topic>Amitriptyline - pharmacology</topic><topic>Amitriptyline - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Corticotropin-Releasing Hormone</topic><topic>Depressive Disorder - blood</topic><topic>Depressive Disorder - drug therapy</topic><topic>Depressive Disorder - physiopathology</topic><topic>Dexamethasone</topic><topic>Drug therapy</topic><topic>Feedback - drug effects</topic><topic>Feedback - physiology</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Neuropharmacology</topic><topic>Older people</topic><topic>Pharmacology. Drug treatments</topic><topic>Pituitary gland</topic><topic>Pituitary-Adrenal System - drug effects</topic><topic>Pituitary-Adrenal System - physiopathology</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychiatry</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HEUSER, I. J. E</creatorcontrib><creatorcontrib>SCHWEIGER, U</creatorcontrib><creatorcontrib>GOTTHARDT, U</creatorcontrib><creatorcontrib>SCHMIDER, J</creatorcontrib><creatorcontrib>LAMMERS, C.-H</creatorcontrib><creatorcontrib>DETTLING, M</creatorcontrib><creatorcontrib>YASSOURIDIS, A</creatorcontrib><creatorcontrib>HOLSBOER, F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Periodicals Index Online Segment 13</collection><collection>Periodicals Index Online Segment 14</collection><collection>Periodicals Index Online Segment 27</collection><collection>Periodicals Index Online</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - West</collection><collection>Primary Sources Access (Plan D) - International</collection><collection>Primary Sources Access & Build (Plan A) - MEA</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Midwest</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Northeast</collection><collection>Primary Sources Access (Plan D) - Southeast</collection><collection>Primary Sources Access (Plan D) - North Central</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Southeast</collection><collection>Primary Sources Access (Plan D) - South Central</collection><collection>Primary Sources Access & Build (Plan A) - UK / I</collection><collection>Primary Sources Access (Plan D) - Canada</collection><collection>Primary Sources Access (Plan D) - EMEALA</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - North Central</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - South Central</collection><collection>Primary Sources Access & Build (Plan A) - International</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - International</collection><collection>Primary Sources Access (Plan D) - West</collection><collection>Periodicals Index Online Segments 1-50</collection><collection>Primary Sources Access (Plan D) - APAC</collection><collection>Primary Sources Access (Plan D) - Midwest</collection><collection>Primary Sources Access (Plan D) - MEA</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Canada</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - UK / I</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - EMEALA</collection><collection>Primary Sources Access & Build (Plan A) - APAC</collection><collection>Primary Sources Access & Build (Plan A) - Canada</collection><collection>Primary Sources Access & Build (Plan A) - West</collection><collection>Primary Sources Access & Build (Plan A) - EMEALA</collection><collection>Primary Sources Access (Plan D) - Northeast</collection><collection>Primary Sources Access & Build (Plan A) - Midwest</collection><collection>Primary Sources Access & Build (Plan A) - North Central</collection><collection>Primary Sources Access & Build (Plan A) - Northeast</collection><collection>Primary Sources Access & Build (Plan A) - South Central</collection><collection>Primary Sources Access & Build (Plan A) - Southeast</collection><collection>Primary Sources Access (Plan D) - UK / I</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - APAC</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - MEA</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HEUSER, I. J. E</au><au>SCHWEIGER, U</au><au>GOTTHARDT, U</au><au>SCHMIDER, J</au><au>LAMMERS, C.-H</au><au>DETTLING, M</au><au>YASSOURIDIS, A</au><au>HOLSBOER, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1996-01-01</date><risdate>1996</risdate><volume>153</volume><issue>1</issue><spage>93</spage><epage>99</epage><pages>93-99</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: This study was done to compare the effects of 6-week
treatment with amitriptyline on hypothalamic-pituitary-adrenocortical (HPA)
regulation in elderly depressed patients and age-matched comparison
subjects. METHOD: A combined dexamethasone-suppression/CRH- stimulation
(dexamethasone/CRH) test was administered before initiation of
amitriptyline treatment and at the end of weeks 1, 3, and 6 of treatment.
Thirty-nine depressed inpatients, mean age = 69 years, completed the study.
Fourteen normal volunteers, mean age = 67 years, served as comparison
subjects. RESULTS: In relation to the comparison subjects, the depressed
patients had a profoundly abnormal HPA response, in particular an
exaggerated cortisol release in the dexamethasone/CRH test. This
abnormality began to disappear after 1 week of treatment with
amitriptyline. In contrast, amitriptyline did not affect neuroendocrine
regulation in the comparison subjects at any time during the test period.
CONCLUSIONS: The data suggest that amitriptyline affects HPA regulation in
hypercortisolemic depression only, and they raise the possibility that
normalization of its feedback control is related to the antidepressive
effect of amitriptyline.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>8540599</pmid><doi>10.1176/ajp.153.1.93</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0002-953X |
| ispartof | The American journal of psychiatry, 1996-01, Vol.153 (1), p.93-99 |
| issn | 0002-953X 1535-7228 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_77911738 |
| source | MEDLINE; Psychiatry Legacy Collection Online Journals 1844-1996; Periodicals Index Online |
| subjects | Adrenal glands Aged Amitriptyline - pharmacology Amitriptyline - therapeutic use Biological and medical sciences Corticotropin-Releasing Hormone Depressive Disorder - blood Depressive Disorder - drug therapy Depressive Disorder - physiopathology Dexamethasone Drug therapy Feedback - drug effects Feedback - physiology Female Hospitalization Humans Hydrocortisone - blood Male Medical sciences Mental depression Neuropharmacology Older people Pharmacology. Drug treatments Pituitary gland Pituitary-Adrenal System - drug effects Pituitary-Adrenal System - physiopathology Psychiatric Status Rating Scales Psychiatry Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology Severity of Illness Index Treatment Outcome |
| title | Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects |
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