The influence of mirtazapine on anterior pituitary hormone secretion in healthy male subjects

Schüle, Cornelius; Baghai, Thomas C.; Goy, Josefine; Bidlingmaier, Martin; Strasburger, Christian J.; Laakmann, G.

doi:10.1007/s00213-002-1148-5

Cited by 42 publications

(31 citation statements)

References 31 publications

(30 reference statements)

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“…The effects of mirtazapine on the sleep-related secretion of cortisol, GH, and prolactin resemble those reported after acute administration of the drug to normal control subjects at daytime (Laakmann et al, 1999;Schüle et al, 2002b). In accordance with these studies, we found a blunting of nocturnal cortisol levels throughout the night, whereas GH and prolactin secretion remained unchanged.…”

Section: Discussionsupporting

confidence: 89%

“…Similar to the decrease of nocturnal cortisol levels in the present study, salivary cortisol was blunted in depressed patients after 1 day of treatment (Laakmann et al, 2004). As discussed by Schüle et al (2002b), the antagonistic action of mirtazapine on alpha 2 , 5HT 2 , and H 1 receptors appears to contribute to the blunting of cortisol. In our study, ACTH secretion showed only a nonsignificant trend to decrease.…”

Section: Discussionsupporting

confidence: 87%

“…In our study, ACTH secretion showed only a nonsignificant trend to decrease. This is in contrast to the finding that ACTH was blunted after mirtazapine in normal controls (Laakmann et al, 1999;Schüle et al, 2002b). Elevated nocturnal cortisol (Linkowski et al, 1987;Steiger et al, 1989) and ACTH (Linkowski et al, 1987) levels are robust findings in acutely depressed patients and mirror HPA overactivity in affective disorders.…”

Section: Discussioncontrasting

confidence: 57%

“…Oral administration of 15 mg mirtazapine in young normal male controls in the morning prompted a decrease of cortisol and adrenocorticotropin (ACTH) plasma concentrations and a decrease of urinary free cortisol excretion, whereas growth hormone (GH) and prolactin levels remained unchanged (Laakmann et al, 1999;Schüle et al, 2002b). These findings were confirmed in another report except for the decrease of prolactin secretion (Schüle et al, 2002a).…”

Section: Introductionmentioning

confidence: 54%

“…Several reports showed that the noradrenergic and specific serotoninergic antidepressant (NaSSA) mirtazapine improves sleep, blunts the hormones of the hypothalamopituitary-adrenocortical (HPA) system, and may prompt increases of appetite and weight (De Boer, 1995;Laakmann et al, 1999Laakmann et al, , 2004Aslan et al, 2002;Kraus et al, 2002;Schüle et al, 2002b). There is no study so far that addresses all these variables.…”

Section: Introductionmentioning

confidence: 99%

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Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine

Schmid

Wichniak

Uhr

et al. 2005

Neuropsychopharmacol

143

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The noradrenergic and specific serotoninergic antidepressant mirtazapine improves sleep, modulates hormone secretion including blunting of hypothalamic-pituitary-adrenocortical (HPA) activity, and may prompt increased appetite and weight gain. The simultaneous investigation of sleep electroencephalogram (EEG) and hormone secretion during antidepressive treatment helps to further elucidate these effects. We examined sleep EEG (for later conventional and quantitative analyses) and the nocturnal concentrations of cortisol, adrenocorticotropin (ACTH), growth hormone (GH), prolactin, melatonin and the key factors of energy balance, ghrelin, and leptin before and after 28 days of treatment of depressed patients (seven women, three men, mean age 39.974.2 years) with mirtazapine. In addition, a sleep EEG was recorded at day 2 and the dexamethasone-corticotropin-releasing hormone (DEX-CRH) test was performed to assess HPA activity at days À3 and 26. Psychometry and mirtazapine plasma concentrations were measured weekly. Already at day 2, sleep continuity was improved. This effect persisted at day 28, when slow-wave sleep, low-delta, theta and alpha activity, leptin and (0300-0700) melatonin increased, and cortisol and ghrelin decreased. ACTH and prolactin remained unchanged. The first two specimens of GH collected after the start of quantitative EEG analysis were reduced at day 28. The DEX-CRH test showed, at day 26, a blunting of the overshoot of ACTH and cortisol found at day À3. The Hamilton Depression score decreased from 32.177.3 to 15.576.7 between days À1 and 28. A weight gain of approximately 3 kg was observed. This unique profile of changes is compatible with the action of mirtazapine at 5-HT-2 receptors, at presynaptic adrenergic alpha 2 receptors, at the HPA system, and on ghrelin and leptin.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine

Schmid

Wichniak

Uhr

et al. 2005

Neuropsychopharmacol

143

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Depression and Anxiety Disorders

2021

The Maudsley Prescribing Guidelines in Psychiatry

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Depression is widely recognised as a major public health problem around the world. The basic principles of prescribing are described in this chapter, along with a summary of NICE guidance. This chapter concentrates on the use of antidepressants and offers advice on drug choice, dosing, switching strategies and sequencing of treatments. Management of treatment‐resistant depression has been informed by the STAR*D programme. The 2019 PANDA trial results support the prescription of selective serotonin reuptake inhibitor antidepressants in a wider group of participants than previously thought, including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalised anxiety disorder. Over the last two decades, ketamine, an uncompetitive N‐Methyl‐D‐Aspartate receptor antagonist and dissociative anaesthetic, has emerged as a novel and effective rapid‐acting antidepressant. Psychotic depression is an under‐identified disorder and may have a life‐time risk of up to 1%.

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Current Awareness in Human Psychopharmacology

2003

Human Psychopharmacology

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Books, Reviews & Symposia; 2 General; 3 Psychotropic Drugs ‐ General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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The influence of mirtazapine on anterior pituitary hormone secretion in healthy male subjects

Cited by 42 publications

References 31 publications

Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine

Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine

Depression and Anxiety Disorders

Current Awareness in Human Psychopharmacology

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