Neuroendocrine Involvement in Therapeutic Mechanisms of Neuroleptic and Antidepressant Drugs: Studies of Thyroid Axis
Sixty-five depressed and 33 paranoid hallucinatory patients were investigated longitudinally for one year to assess short- and long term therapeutic outcome with antidepressant and neuroleptic drugs, respectively. The patients’ thyrotropin (TSH) response to thyrotropin releasing hormone (TRH) was studied at admission, during inpatient treatment and at discharge. Decreased TSH responses at outcome, and normalisation of these pathological responses during treatment were associated with the highest chance for recovery. TSH responses which persisted blunted at discharge were associated with a higher relapse rate during the one year following. It is hypothesized that the blunted TSH response may reflect a nonspecific cerebral malactivation, which is disactivated by the therapeutic effects of neuroleptic and antidepressant drugs.
KeywordsAnorexia Nervosa Antidepressant Drug Thyrotropin Release Hormone Biological Psychiatry Neuroleptic Drug
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- 4.G. Langer, G. Koinig, G. Schoenbeck, H. Aschauer and F. Resch, The therapeutic effects of antidepressants appear to involve neuroendocrine mechanisms, in “Biological psychiatry,” C. Perris, G. Struwe and B. Janssen, eds., Elsevier/North Holland (1981).Google Scholar
- 5.G. Langer, H. Aschauer, G. Koinig, H. Reiter, G. Schoenbeck and O. Lesch, Neuroendocrine factors in the treatment of schizophrenic patients: relationship with haloperidol level and treatment outcome, in: “Biological Psychiatry,” C. Perris, G. Struwe and B. Janssen, eds., Elsevier/North Holland (1981).Google Scholar
- 6.L. Kirkstein, M.S. Gold, D. Martin and A.L.C. Pottash, Clinical correlates of the TRH infusion test in primary depression, J. Clin. Psychiatry 43: 5, 191–194 (1982).Google Scholar
- 7.R.L. Spitzer, J. Endicott and E. Robins, “Research diagnostic criteria for a selected group of psychiatric disorders,” third edition, N.Y.S. psychiatric institute, New York 10032, (1978).Google Scholar
- 11.G. Langer, G. Schoenbeck, G. Koinig and H. Aschauer, Neuroendocrine mechanisms in the therapeutic effects of antidepressant drugs: The thyroid axis hypothesis, in: “Typical and atypical antidepressants,” E. Costa and G. Racagni, eds., Raven Press, New York (1982).Google Scholar
- 13.J. Tuomisto, Neuropharmacological intervention on the pituitary-hypothalamic relationship, Ann, clin. res. 10: 120–132 (1978).Google Scholar
- 15.H. Heimann, Auf dem Wege zu einer einheitlichen psychophysiologischen Theorie depressiver Syndrome, Praxis Psychother. Psychosom. 24: 281–299 (1979).Google Scholar