Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects

Isabella J.E. Heuser*, Ulrich Schweiger, Ulrike Gotthardt, Jürgen Schmider, Claas H. Lammers, Michael Dettling, A. Yassouridis, Florian Holsboer

*Corresponding author for this work
240 Citations (Scopus)

Abstract

Objective: This study was done to compare the effects of 6-week treatment with amitriptyline on hypothalamic-pituitary adrenocortical (HPA) regulation in elderly depressed patients and age-matched comparison subjects. Method: A combined dexamethasone-suppression/CRH-stimulation (dexamethasone/CRH) test was administered before initiation of amitriptyline treatment and at the end of weeks 1, 3, and 6 of treatment. Thirty-nine depressed inpatients, mean age-69 years, completed the study. Fourteen normal volunteers, mean age=67 years, served as comparison subjects. Results: In relation to the comparison subjects, the depressed patients had a profoundly abnormal HPA response, in particular an exaggerated cortisol release in the dexamethasone/CRH test. This abnormality began to disappear after 1 week of treatment with amitriptyline. In contrast, amitriptyline did not affect neuroendocrine regulation in the comparison subjects at any time during the test period. Conclusions: The data suggest that amitriptyline affects HPA regulation in hypercortisolemic depression only, and they raise the possibility that normalization of its feedback control is related to the antidepressive effect of amitriptyline.

Original languageEnglish
JournalAmerican Journal of Psychiatry
Volume153
Issue number1
Pages (from-to)93-99
Number of pages7
ISSN0002-953X
DOIs
Publication statusPublished - 01.1996

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)

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