Influence of mirtazapine on urinary free cortisol excretion in depressed patients

Mirtazapine has been shown to acutely inhibit cortisol secretion in healthy subjects. In the present study, the impact of mirtazapine treatment on urinary free cortisol (UFC) excretion was investigated in depression. Twenty patients (six men, 14 women) suffering from major depression according to DS...

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Bibliographic Details
Published in:	Psychiatry research Vol. 120; no. 3; pp. 257 - 264
Main Authors:	Schule, Cornelius, Baghai, Thomas, Rackwitz, Constanze, Laakmann, Gregor
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 15-10-2003 Elsevier
Subjects:	Adult Antidepressive Agents, Tricyclic - adverse effects Antidepressive Agents, Tricyclic - therapeutic use Biological and medical sciences Depressive disorder Depressive Disorder, Major - drug therapy Depressive Disorder, Major - psychology Depressive Disorder, Major - urine Dose-Response Relationship, Drug Drug Administration Schedule Female HPA axis Humans Hydrocortisone - urine Male Medical sciences Mianserin - adverse effects Mianserin - analogs & derivatives Mianserin - therapeutic use Middle Aged Mirtazapine Neuropharmacology Personality Inventory Pharmacology. Drug treatments Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology Sex Factors Treatment Outcome Urinary free cortisol Mirtazapine HPA axis Urinary free cortisol Depressive disorder Hypothalamohypophysoadrenal axis Psychotropic Central nervous system Neuroendocrine regulation Hydrocortisone Glucocorticoid Encephalon Dose activity relation Antidepressant agent Evolution Mood disorder Human Urine Steroid hormone Treatment efficiency Depression Tetracyclic compound Symptomatology Chemotherapy Treatment Follow up study Adrenal hormone Severity score Comparative study
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Summary:	Mirtazapine has been shown to acutely inhibit cortisol secretion in healthy subjects. In the present study, the impact of mirtazapine treatment on urinary free cortisol (UFC) excretion was investigated in depression. Twenty patients (six men, 14 women) suffering from major depression according to DSM-IV criteria were treated with mirtazapine for 3 weeks. The patients received 15 mg mirtazapine on day 0; 30 mg mirtazapine on day 1; and 45 mg mirtazapine per day from day 2 to the end of the study (day 21). UFC excretion was measured before treatment (day 1), at the beginning (day 0), after 1 week (day 7) and after 3 weeks (day 21) of treatment with mirtazapine. Urine samples were collected from 08:00 to 08:00 h the following day. On the days of urine sampling, the severity of depressive symptoms was assessed using the 21-item version of the Hamilton Rating Scale for Depression (21-HAMD). There was a significant reduction of UFC excretion during 3-week mirtazapine therapy, which was already obvious after the first day of treatment (day 0). However, there were no significant across-subjects correlations between UFC reduction and decrease in 21-HAMD sum scores. Apparently, the mirtazapine-induced rapid reduction of cortisol secretion in depressed patients is not necessarily correlated with a favorable therapeutic response.
ISSN:	0165-1781 1872-7123
DOI:	10.1016/S0165-1781(03)00204-X