Effects of mirtazapine on dehydroepiandrosterone-sulfate and cortisol plasma concentrations in depressed patients

Journal of Psychiatric Research
Cornelius SchüleRainer Rupprecht

Abstract

Among the neuroactive steroids, dehydroepiandrosterone sulfate (DHEA-S) is at least in part produced in the adrenal gland and is therefore under the control of the hypothalamic-pituitary-adrenocortical (HPA)-system. In the present study, the impact of mirtazapine on DHEA-S and cortisol (COR) levels was investigated in relation to clinical response in depressed patients. A total of 23 inpatients suffering from a major depressive episode (DSM-IV criteria) underwent 5-week treatment with mirtazapine (45 mg/day). Plasma samples were taken weekly at 0800 h and quantified for COR and DHEA-S levels. Mirtazapine significantly reduced both COR and DHEA-S concentrations, but had no impact on the COR/DHEA-S ratio. The percentage decrease of DHEA-S, but not that of COR was significantly and positively correlated with the percentage reduction in the sum score of the Hamilton Depression Rating Scale at week 5, suggesting a relationship between DHEA-S reduction and clinical efficacy of mirtazapine. There was a significant positive correlation between the decline in COR and DHEA-S levels. Apparently, the decrease in COR and DHEA-S concentrations conjointly reflects an attenuating impact of mirtazapine on HPA axis activity, thereby decreasing t...Continue Reading

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Citations

Sep 16, 2009·Journal of Psychiatric Research·Michael KellnerAlexander Yassouridis
Sep 15, 2009·Journal of Psychiatric Research·Martha S McKay, Konstantine K Zakzanis
Jul 11, 2009·Expert Review of Neurotherapeutics·Cornelius SchüleRainer Rupprecht
Jan 25, 2011·Expert Opinion on Therapeutic Targets·Kanwaljit ChopraAnurag Kuhad
Sep 21, 2013·International Journal of Psychiatry in Clinical Practice·Panagiotis OulisManolis Markianos

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