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Changes of sleep architecture, spectral composition of sleep EEG, the nocturnal secretion of cortisol, ACTH, GH, prolactin, melatonin, ghrelin, and leptin, and the DEX-CRH test in depressed patients during treatment with mirtazapine.
Neuropsychopharmacology. 2006 Apr; 31(4):832-44.N

Abstract

The noradrenergic and specific serotoninergic antidepressant mirtazapine improves sleep, modulates hormone secretion including blunting of hypothalamic-pituitary-adrenocortical (HPA) activity, and may prompt increased appetite and weight gain. The simultaneous investigation of sleep electroencephalogram (EEG) and hormone secretion during antidepressive treatment helps to further elucidate these effects. We examined sleep EEG (for later conventional and quantitative analyses) and the nocturnal concentrations of cortisol, adrenocorticotropin (ACTH), growth hormone (GH), prolactin, melatonin and the key factors of energy balance, ghrelin, and leptin before and after 28 days of treatment of depressed patients (seven women, three men, mean age 39.9+/-4.2 years) with mirtazapine. In addition, a sleep EEG was recorded at day 2 and the dexamethasone-corticotropin-releasing hormone (DEX-CRH) test was performed to assess HPA activity at days -3 and 26. Psychometry and mirtazapine plasma concentrations were measured weekly. Already at day 2, sleep continuity was improved. This effect persisted at day 28, when slow-wave sleep, low-delta, theta and alpha activity, leptin and (0300-0700) melatonin increased, and cortisol and ghrelin decreased. ACTH and prolactin remained unchanged. The first two specimens of GH collected after the start of quantitative EEG analysis were reduced at day 28. The DEX-CRH test showed, at day 26, a blunting of the overshoot of ACTH and cortisol found at day -3. The Hamilton Depression score decreased from 32.1+/-7.3 to 15.5+/-6.7 between days -1 and 28. A weight gain of approximately 3 kg was observed. This unique profile of changes is compatible with the action of mirtazapine at 5-HT-2 receptors, at presynaptic adrenergic alpha 2 receptors, at the HPA system, and on ghrelin and leptin.

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Authors+Show Affiliations

Schmid DA
Max Planck Institute of Psychiatry, Munich, Germany.
Wichniak A
No affiliation info available
Uhr M
No affiliation info available
Ising M
No affiliation info available
Brunner H
No affiliation info available
Held K
No affiliation info available
Weikel JC
No affiliation info available
Sonntag A
No affiliation info available
Steiger A
No affiliation info available

MeSH

Adrenocorticotropic HormoneAdultAnimalsAntidepressive Agents, TricyclicArea Under CurveBody WeightCircadian RhythmDepressionDexamethasoneDose-Response Relationship, DrugElectroencephalographyEndocrine SystemFemaleGhrelinGrowth HormoneHormonesHumansHydrocortisoneImmunoradiometric AssayLeptinMaleMelatoninMianserinMiddle AgedMirtazapinePeptide HormonesProlactinPsychometricsSleepTime Factors

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16237393

Citation

Schmid, Dagmar A., et al. "Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients During Treatment With Mirtazapine." Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, vol. 31, no. 4, 2006, pp. 832-44.
Schmid DA, Wichniak A, Uhr M, et al. Changes of sleep architecture, spectral composition of sleep EEG, the nocturnal secretion of cortisol, ACTH, GH, prolactin, melatonin, ghrelin, and leptin, and the DEX-CRH test in depressed patients during treatment with mirtazapine. Neuropsychopharmacology. 2006;31(4):832-44.
Schmid, D. A., Wichniak, A., Uhr, M., Ising, M., Brunner, H., Held, K., Weikel, J. C., Sonntag, A., & Steiger, A. (2006). Changes of sleep architecture, spectral composition of sleep EEG, the nocturnal secretion of cortisol, ACTH, GH, prolactin, melatonin, ghrelin, and leptin, and the DEX-CRH test in depressed patients during treatment with mirtazapine. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 31(4), 832-44.
Schmid DA, et al. Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients During Treatment With Mirtazapine. Neuropsychopharmacology. 2006;31(4):832-44. PubMed PMID: 16237393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes of sleep architecture, spectral composition of sleep EEG, the nocturnal secretion of cortisol, ACTH, GH, prolactin, melatonin, ghrelin, and leptin, and the DEX-CRH test in depressed patients during treatment with mirtazapine. AU - Schmid,Dagmar A, AU - Wichniak,Adam, AU - Uhr,Manfred, AU - Ising,Marcus, AU - Brunner,Hans, AU - Held,Katja, AU - Weikel,Jutta C, AU - Sonntag,Annette, AU - Steiger,Axel, PY - 2005/10/21/pubmed PY - 2006/5/26/medline PY - 2005/10/21/entrez SP - 832 EP - 44 JF - Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology JO - Neuropsychopharmacology VL - 31 IS - 4 N2 - The noradrenergic and specific serotoninergic antidepressant mirtazapine improves sleep, modulates hormone secretion including blunting of hypothalamic-pituitary-adrenocortical (HPA) activity, and may prompt increased appetite and weight gain. The simultaneous investigation of sleep electroencephalogram (EEG) and hormone secretion during antidepressive treatment helps to further elucidate these effects. We examined sleep EEG (for later conventional and quantitative analyses) and the nocturnal concentrations of cortisol, adrenocorticotropin (ACTH), growth hormone (GH), prolactin, melatonin and the key factors of energy balance, ghrelin, and leptin before and after 28 days of treatment of depressed patients (seven women, three men, mean age 39.9+/-4.2 years) with mirtazapine. In addition, a sleep EEG was recorded at day 2 and the dexamethasone-corticotropin-releasing hormone (DEX-CRH) test was performed to assess HPA activity at days -3 and 26. Psychometry and mirtazapine plasma concentrations were measured weekly. Already at day 2, sleep continuity was improved. This effect persisted at day 28, when slow-wave sleep, low-delta, theta and alpha activity, leptin and (0300-0700) melatonin increased, and cortisol and ghrelin decreased. ACTH and prolactin remained unchanged. The first two specimens of GH collected after the start of quantitative EEG analysis were reduced at day 28. The DEX-CRH test showed, at day 26, a blunting of the overshoot of ACTH and cortisol found at day -3. The Hamilton Depression score decreased from 32.1+/-7.3 to 15.5+/-6.7 between days -1 and 28. A weight gain of approximately 3 kg was observed. This unique profile of changes is compatible with the action of mirtazapine at 5-HT-2 receptors, at presynaptic adrenergic alpha 2 receptors, at the HPA system, and on ghrelin and leptin. SN - 0893-133X UR - https://www.unboundmedicine.com/medline/citation/16237393/Changes_of_sleep_architecture_spectral_composition_of_sleep_EEG_the_nocturnal_secretion_of_cortisol_ACTH_GH_prolactin_melatonin_ghrelin_and_leptin_and_the_DEX_CRH_test_in_depressed_patients_during_treatment_with_mirtazapine_ L2 - https://doi.org/10.1038/sj.npp.1300923 DB - PRIME DP - Unbound Medicine ER -