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Effect of single-dose sertraline on the hypothalamus-pituitary-adrenal system, autonomic nervous system, and platelet function.
J Clin Psychopharmacol. 2007 Dec; 27(6):602-6.JC

Abstract

OBJECTIVE

Pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs) is thought to decrease coronary risk in patients with depressive disorder. Selective serotonin reuptake inhibitor intake may (1) attenuate the hypothalamus-pituitary-adrenal (HPA) system, (2) improve disturbances of the autonomous nervous system, and (3) dampen the aggregability of platelets. There is only limited information about the influence of acute treatment with SSRIs on these systems, which is especially important for the initiation of therapy in high-risk cardiac patients. We compared the reaction of these systems to physical stress with single-dose SSRI treatment (100 mg) with that of placebo treatment.

METHODS

Using a double-blind, crossover, placebo-controlled design, we assessed HPA system activity via serum cortisol and corticotropin as well as sympathetic nervous system by determining serum norepinephrine and epinephrine levels at baseline and as a response to stress. Analysis of heart rate variability (HRV) provided information on sympathetic/parasympathetic balance. Platelet activity was measured via flow-cytometric determination of platelet surface activation markers along with the serotonin (5-HT) uptake of platelets.

RESULTS

We studied 12 healthy young men under placebo and verum conditions. We found higher HPA system activity at baseline and after physical activity under sertraline when compared with placebo, no difference in sympathetic nervous system activity after physical exertion and only slightly heightened baseline epinephrine values after sertraline intake. No difference was seen between sertraline and placebo intake regarding platelet activity and 5-HT uptake, HRV, blood pressure, and HR.

CONCLUSIONS

Initiating sertraline treatment increases HPA system activity and epinephrine concentrations. We found no clinically relevant effect of single-dose sertraline treatment on autonomous nervous function, platelet activity, or platelet 5-HT uptake. These findings may not be extrapolated to patients with affective or cardiac disorders or to other SSRIs.

Authors+Show Affiliations

Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18004127

Citation

Ahrens, Thorben, et al. "Effect of Single-dose Sertraline On the Hypothalamus-pituitary-adrenal System, Autonomic Nervous System, and Platelet Function." Journal of Clinical Psychopharmacology, vol. 27, no. 6, 2007, pp. 602-6.
Ahrens T, Frankhauser P, Lederbogen F, et al. Effect of single-dose sertraline on the hypothalamus-pituitary-adrenal system, autonomic nervous system, and platelet function. J Clin Psychopharmacol. 2007;27(6):602-6.
Ahrens, T., Frankhauser, P., Lederbogen, F., & Deuschle, M. (2007). Effect of single-dose sertraline on the hypothalamus-pituitary-adrenal system, autonomic nervous system, and platelet function. Journal of Clinical Psychopharmacology, 27(6), 602-6.
Ahrens T, et al. Effect of Single-dose Sertraline On the Hypothalamus-pituitary-adrenal System, Autonomic Nervous System, and Platelet Function. J Clin Psychopharmacol. 2007;27(6):602-6. PubMed PMID: 18004127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of single-dose sertraline on the hypothalamus-pituitary-adrenal system, autonomic nervous system, and platelet function. AU - Ahrens,Thorben, AU - Frankhauser,Pascal, AU - Lederbogen,Florian, AU - Deuschle,Michael, PY - 2007/11/16/pubmed PY - 2008/2/27/medline PY - 2007/11/16/entrez SP - 602 EP - 6 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 27 IS - 6 N2 - OBJECTIVE: Pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs) is thought to decrease coronary risk in patients with depressive disorder. Selective serotonin reuptake inhibitor intake may (1) attenuate the hypothalamus-pituitary-adrenal (HPA) system, (2) improve disturbances of the autonomous nervous system, and (3) dampen the aggregability of platelets. There is only limited information about the influence of acute treatment with SSRIs on these systems, which is especially important for the initiation of therapy in high-risk cardiac patients. We compared the reaction of these systems to physical stress with single-dose SSRI treatment (100 mg) with that of placebo treatment. METHODS: Using a double-blind, crossover, placebo-controlled design, we assessed HPA system activity via serum cortisol and corticotropin as well as sympathetic nervous system by determining serum norepinephrine and epinephrine levels at baseline and as a response to stress. Analysis of heart rate variability (HRV) provided information on sympathetic/parasympathetic balance. Platelet activity was measured via flow-cytometric determination of platelet surface activation markers along with the serotonin (5-HT) uptake of platelets. RESULTS: We studied 12 healthy young men under placebo and verum conditions. We found higher HPA system activity at baseline and after physical activity under sertraline when compared with placebo, no difference in sympathetic nervous system activity after physical exertion and only slightly heightened baseline epinephrine values after sertraline intake. No difference was seen between sertraline and placebo intake regarding platelet activity and 5-HT uptake, HRV, blood pressure, and HR. CONCLUSIONS: Initiating sertraline treatment increases HPA system activity and epinephrine concentrations. We found no clinically relevant effect of single-dose sertraline treatment on autonomous nervous function, platelet activity, or platelet 5-HT uptake. These findings may not be extrapolated to patients with affective or cardiac disorders or to other SSRIs. SN - 0271-0749 UR - https://www.unboundmedicine.com/medline/citation/18004127/Effect_of_single_dose_sertraline_on_the_hypothalamus_pituitary_adrenal_system_autonomic_nervous_system_and_platelet_function_ L2 - https://doi.org/10.1097/jcp.0b013e31815abf0e DB - PRIME DP - Unbound Medicine ER -