Plasma neurotransmitters, blood pressure, and heart rate during supine resting, orthostasis, and moderate exercise in dysthymic depressed patients

Lechín, Fuad; Bertha, van der Dijs; Orozco, Beatriz; Lechin, Alex E.; Baez, Scarlet; Lechin, Marcel E.; Rada, Isaís; Acosta, Emilio; Arocha, Luis; Jiménez, Vladimir; León, Gladys; García, Zulay

doi:10.1016/0006-3223(94)00220-w

Cited by 30 publications

(14 citation statements)

References 43 publications

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“…We will comment briefly on this second test. However, complete results will be presented in another paper [34].…”

Section: Methodsmentioning

confidence: 98%

“…Hence, plasma adrenaline basal levels increase during exercise but not at orthostasis, in normal humans. On the other hand, plasma noradrena line increases both in orthostasis and exercise periods indicating neural sympathetic (central noradrenergic) re sponse to both physiological tests [32][33][34]. According to this, we postulate that subjects who fail to cope with stress should show plasma adrenaline increase during orthosta sis and consequently a significant reduction of the NA/ AD ratio, while in depressed subjects it should not be registered.…”

Section: Introductionmentioning

confidence: 99%

“…However, we postu lated that the latter would show adrenal hyperresponsive ness when challenged to the orthostasis-exercise test. Equally important are the responses of major depressed and dysthymic depressed patients to this test, although they presented different profiles [36,37]. Both these groups share a low adrenal gland responsiveness and, as such, would aid in establishing an accurate procedure for distinguishing the three groups of patients who otherwise may present overlapping clinical features.…”

Section: Introductionmentioning

confidence: 99%

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Plasma Neurotransmitters, Blood Pressure and Heart Rate during Supine Resting, Orthostasis and Moderate Exercise in Severely III Patients: A Model of Failing to Cope with Stress

Lechín

Dijs

Orozco

et al. 1996

Psychother Psychosom

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Background: Previous clinical research has shown that severely ill (somatic) as well as many psychosomatic patients show raised noradrenaline (NA), adrenaline (AD), cortisol, free serotonin (f5HT) and platelet aggregability. Conversely, they show reduced NA/AD plasma ratio and platelet serotonin (p5HT). They also show adrenal hyperresponsiveness to an oral glucose load. These findings are opposed to those observed in depressed patients who show adrenal gland sympathetic hyporesponsiveness and neural sympathetic hyperactivity. Objective: To investigate adrenal gland and neural sympathetic systems as well as the other parameters in nondrepressed severely ill patients through the orthostasis exercise stress test which in normals triggers NA but no AD rise. Methods: We investigated 35 severely ill patients and their age- and sex-paired controls. Systolic, diastolic pulse pressure (PP), heart rate and neuroendocrine parameters were measured supine (0 min), at orthostasis (1 min) and exercise (5 min). A second test was performed 2 weeks later, after atropine injection. Multivariate analysis of variance, paired t test and Pearson product-moment test were employed. Results: The normal PP orthostasis fall was not observed in patients. At this period, an abnormal AD peak substituted the normal NA peak. The normal p5HT-f5HT orthostasis-exercise peaks were absent in patients. Cortisol and platelet aggregability were raised in patients. Conclusions: Severely ill (somatic) patients responded to the orthostasis-exercise stress test with adrenal and corticosuprarenal but not neural sympathetic activity. They did not show the normal parasympathetic activity at orthostasis. This adrenal gland sympathetic hyperactivity registered in somatic patients is similar to that observed in mammals which fail to cope with stress and contrary to the profile registered in depressed subjects who show NA but not AD rise.

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“…We will comment briefly on this second test. However, complete results will be presented in another paper [34].…”

Section: Methodsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Plasma Neurotransmitters, Blood Pressure and Heart Rate during Supine Resting, Orthostasis and Moderate Exercise in Severely III Patients: A Model of Failing to Cope with Stress

Lechín

Dijs

Orozco

et al. 1996

Psychother Psychosom

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“…114 While limited attention has been devoted to the analysis of monoamine abnormalities in dysthymia, reduced levels of plasma NE coupled with elevated platelet and free 5-HT were evident in dysthymia. 115 Further, following exercise, changes of epinephrine levels were relatively modest in dysthymic patients relative to control subjects. Thus, it was posited that dysthymia may be associated with altered adrenal responsivity to environmental challenges, as well as heightened sympathetic tone as reflected by the elevated free 5-HT levels.…”

Section: Biological Aspects Of Dysthymiamentioning

confidence: 95%

Dysthymia: a review of pharmacological and behavioral factors

et al. 2000

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Although dysthymia, a chronic, low-grade form of depression, has a morbidity rate as high as that of major depression, and increases the risk for major depressive disorder, limited information is available concerning the etiology of this illness. In the present report we review literature concerning the biological and characterological features of dysthymia, the effectiveness of antidepressant treatments, the influence of stressors in the precipitation and maintenance of the disorder, and both quality of life and psychosocial correlates of the illness. We also provisionally suggest that dysthymia may stem from disturbances of neuroendocrine and neurotransmitter functioning (eg, corticotropin releasing hormone and arginine vasopressin within the hypothalamus, or alternatively monoamine variations within several extrahypothalamic sites), and may also involve cytokine activation. The central disturbances may reflect phenotypic variations of neuroendocrine processes or sensitization of such mechanisms. It is suggested that chronic stressor experiences or stressors encountered early in life lead to the phenotypic neurochemical alterations, which then favor the development of the dysthymic state. Owing to the persistence of the neurochemical disturbances, vulnerability to double depression is increased, and in this instance treatment with antidepressants may attenuate the symptoms of major depression but not those of the basal dysthymic state. Moreover, the residual features of depression following treatment may be indicative of underlying neurochemical disturbances, and may also serve to increase the probability of illness recurrence or relapse. Molecular Psychiatry (2000) 5, 242-261.

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“…The former is significantly reduced in major (endogenous) depression (ED) patients [1]; whereas it is raised in dysthymic depression [2]. In addition, f5-HT is elevated in patients affected by the uncoping stress syndrome because of platelet aggregability triggered by raised levels of epinephrine (E) [3].…”

Section: Introductionmentioning

confidence: 99%

Pathophisiological and Neuropharmacological Mechanisms Under- lying the Therapeutical Effects of Tianeptine

Lechín¹,

Dijs²

2017

MEDJ

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Background:Tianeptine, a drug that enhances rather than inhibits serotonin uptake by platelets and serotonergic axons, is able to act as an antidepressant and/or anti-stress drug. Methods:The former effect should be attributed to its ability to reduce neural sympathetic over activity, whereas the latter to the interference by the drug to the hypothalamic stress cascade which includes corticotropin releasing factor + ACTH + cortisol secretion. Conclusion:This singular mechanism should be taken into account when the drug is prescribed as a therapeutic agent.

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Plasma neurotransmitters, blood pressure, and heart rate during supine resting, orthostasis, and moderate exercise in dysthymic depressed patients

Cited by 30 publications

References 43 publications

Plasma Neurotransmitters, Blood Pressure and Heart Rate during Supine Resting, Orthostasis and Moderate Exercise in Severely III Patients: A Model of Failing to Cope with Stress

Plasma Neurotransmitters, Blood Pressure and Heart Rate during Supine Resting, Orthostasis and Moderate Exercise in Severely III Patients: A Model of Failing to Cope with Stress

Dysthymia: a review of pharmacological and behavioral factors

Pathophisiological and Neuropharmacological Mechanisms Under- lying the Therapeutical Effects of Tianeptine

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