The influence of 4–week treatment with sertraline on the combined T3/TRH test in depressed patients

Abstract

In the present study, the influence of a 4-week treatment with sertraline on the regulation of hypothalamic-pituitary-thyroid (HPT) axis activity in depression was investigated, in particular the impact of sertraline on the thyroid receptor (TR)-mediated negative feedback control as measured by the combined T3/TRH test. In 20 drug-free patients (8 men, 12 women) suffering from a major depressive episode according to DSM-IV criteria the single TRH-stimulation test (administration of 200 microg TRH at 09:00h) was carried out followed by a combined T3/TRH test (pre-treatment with 40 microg 3,5,3'-triiodothyronine [T3] the night before; administration of 200 microg TRH at 09:00h the next day). After 4 weeks of treatment with sertraline at a standard dosage of 50 mg/day, both the single TRH test and the combined T3/TRH test were repeated in the depressed patients. Using repeated-measures ANOVA for statistical analysis, antidepressant therapy with sertraline did not have any significant impact on the TRH-induced TSH and prolactin stimulation (deltaTSH, deltaPRL) during the single TRH test nor during the combined T3/TRH test, neither in responders (n = 10) nor in non-responders (n = 10). Moreover, the percentage suppression of TRH-induced TSH stimulation (deltaTSH) after pre-treatment with 40 microg T3 was comparable before (-61.07%) and after the 4-week treatment with sertraline (-58.92%). Apparently, the therapeutic efficacy of antidepressants such as sertraline is not related to the regulation of HPT axis activity in depressed patients.

Relationship between thyroid hormone and sex hormone levels and non-suicidal self-injury in male adolescents with depression

“…Clinical studies have shown that sertraline is significantly more effective than placebo in the treatment of depression in children and adolescents ( 25 ), and has few and mild adverse effects that are well tolerated by most children ( 26 ). Most antipsychotic drugs affect thyroid hormones, however, it has been shown that sertraline use has no effect on thyroid hormones ( 27 , 28 ). Therefore, the NSSI group was treated with sertraline monotherapy with a starting dose of 50 mg/d, which was gradually increased to 100–200 mg/d within 2 weeks for 6 weeks, and no other antidepressants, antipsychotics or mood stabilizers were applied during the treatment period, and lorazepam could be given intermittently orally at night if the patients developed severe insomnia disorder.…”