Specific effects of escitalopram on neuroendocrine response

Hawken, Emily R.; Owen, James; Hudson, Robert; Delva, Nicholas J.

doi:10.1007/s00213-009-1633-1

Cited by 5 publications

(6 citation statements)

References 53 publications

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“…Neither the mechanism nor the significance of these findings is clear. Single doses of SSRIs have been demonstrated to increase plasma cortisol concentrations (47, 48); however, longer term studies have been less consistent with most studies finding plasma, salivary or urinary cortisol to either be unchanged or decreased after SSRI administration (42, 49-51). These longer term treatment studies have generally measured cortisol concentrations in the context of treating psychiatric disorders such as depression, generalized anxiety disorder or panic disorder, which are associated with increased cortisol concentrations (50-52).…”

Section: Discussionmentioning

confidence: 99%

Effect of Paroxetine on Physiological Response to Stress and Smoking

Kotlyar

Al’Absi

Thuras

et al. 2013

Psychosomatic Medicine

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Objective Smokers often smoke during stressful events, which leads to large increases in cardiovascular measures such as blood pressure (BP) and heart rate (HR). Since exaggerated cardiovascular response to stress is associated with cardiovascular disease risk, this study examined paroxetine’s effect on the physiological response to combining stress and smoking. Methods Sixty-two participants completed this randomized, double blind, cross-over study in which BP, HR, plasma epinephrine, norepinephrine (NE) and cortisol concentrations were measured at rest, while smoking and during a speech and math task. Laboratory sessions occurred after one month of paroxetine and after one month of placebo. Results Significant increases occurred for all measures (except cortisol) during smoking with further increases occurring during the speech task (time effect p values <0.001). After one month of paroxetine, NE and HR values were lower and cortisol values higher (vs. placebo) throughout the lab session (treatment effect p values < 0.001). Treatment × time effects were observed for blood pressure and heart rate (all p<0.01). For systolic and diastolic BP, a smaller increase (from baseline to measures during speech) was observed after paroxetine compared to placebo (both p <0.006). In both measures, the increase in response to smoking was similar for both treatments, however the further increase during the speech was smaller when taking paroxetine (vs. placebo). Conclusions This study suggests that paroxetine affects physiological response to stress in smokers. Further research is needed to determine the impact of these results on cardiovascular health.

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Section: Discussionmentioning

confidence: 99%

Effect of Paroxetine on Physiological Response to Stress and Smoking

Kotlyar

Al’Absi

Thuras

et al. 2013

Psychosomatic Medicine

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“…Binding of serotonin to these receptors leads to pupillary sphincter relaxation and thereby mydriasis 38 . The neuro‐endocrine findings also point in the direction of SERT binding, as other serotonergic compounds such as fenfluramine and escitalopram are known to respectively increase cortisol and cortisol and prolactin levels in healthy volunteers 9,11 . It could be argued that the endocrine effects can be caused by pituitary stimulation, outside the BBB and CNS.…”

Section: Discussionmentioning

confidence: 99%

“…8 In addition to the NeuroCart tests, serum cortisol and prolactin levels were measured as biomarkers for serotonergic effects, as escitalopram and citalopram are known to increase levels of these hormones. 9 Although it is uncertain whether growth hormone levels are influenced by serotonergic compounds, 10 serum growth hormone levels were also measured.…”

Section: Introductionmentioning

confidence: 99%

Pharmacological profile of ALKS 7119, an investigational compound evaluated for the treatment of neuropsychiatric disorders, in healthy volunteers

Dijkstra

Zuiker

Siebenga

et al. 2022

Brit J Clinical Pharma

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Methods: In 10 cohorts (n = 10 subjects each), PK, safety and PD (NeuroCart tests, measuring neurophysiologic effects [pupillometry, pharmaco-EEG (pEEG)], visuomotor coordination, alertness, [sustained] attention [saccadic peak velocity, adaptive tracking], subjective drug effects [VAS Bowdle and VAS Bond and Lader] and postural stability [body sway]) were evaluated. Neuroendocrine effects (cortisol, prolactin, growth hormone) were measured. Data were analysed over the 12-hour post-dose period using mixed-effects model for repeated measure (MMRM) with baseline as covariate.Results: ALKS 7119 demonstrated linear PK and was generally well tolerated. QTcF interval increases of 30-60 ms compared to baseline were observed with ALKS 7119 doses of ≥50 mg without related adverse events. Significant increases in left and right pupil/iris ratio were observed at dose levels ≥50 mg (estimate of difference [95% CI], P-value) (0.04 [0.01; 0.07], P < .01) and (0.06 [0.03; 0.09], P = .01), respectively. From dose levels ≥50 mg significant increases (% change) of serum cortisol (51.7 [8.4; 112.3], P = .02) and prolactin (77.9 [34.2; 135.8], P < .01) were observed. Conclusion:In line with ALKS 7119's in vitro pharmacological profile, the clinical profile observed in this study is most comparable to SERT inhibition.

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“… 4) One study comparing citalopram and escitalopram showed that after a single dose, escitalopram acted centrally (and not peripherally) and increased prolactin and cortisol levels while also exhibiting successful blockade of cortisol following administration of dexamethasone. 5) …”

Section: Discussionmentioning

confidence: 99%

Escitalopram-Induced Amenorrhea and False Positive Urine Pregnancy Test

et al. 2017

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Escitalopram is a selective serotonin reuptake inhibitor antidepressant approved by the Food and Drug Administration for the treatment of major depressive disorder and generalized anxiety disorder. A 34-year-old female patient with major depressive disorder developed amenorrhea and had a false-positive urine pregnancy test after initiation of escitalopram treatment. To our knowledge, no published case report of amenorrhea and false-positive urine pregnancy tests in women taking escitalopram exists. This case report suggests that women of child-bearing age should be carefully monitored for amenorrhea while they are on an antidepressant treatment regimen.

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Specific effects of escitalopram on neuroendocrine response

Abstract: This is the first study to prove that a single dose of escitalopram acts centrally and not peripherally, providing further support of the use of oral escitalopram as a probe for brain serotonergic function.

Cited by 5 publications

References 53 publications

Effect of Paroxetine on Physiological Response to Stress and Smoking

Effect of Paroxetine on Physiological Response to Stress and Smoking

Pharmacological profile of ALKS 7119, an investigational compound evaluated for the treatment of neuropsychiatric disorders, in healthy volunteers

Escitalopram-Induced Amenorrhea and False Positive Urine Pregnancy Test

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