RESUMEN
INTRODUCTION: While there is extensive literature on HPA system activity in acutely depressed patients, there is only limited information about the presence of hypercortisolemia during the interepisode interval of affective disorders. We hypothesized an increase in HPA system activity in depressed patients compared to controls, and proposed that night-time cortisol excretion during follow-up will depend on clinical outcome. METHODS: We measured night-time cortisol excretion in 27 patients during an acute episode of major depression as well as a 20-week follow-up. 40 healthy subjects served as control group. RESULTS: During the acute episode depressed patients showed increased levels of night-time cortisol excretion compared to healthy controls. Both, patients with full and sustained remission (n=8) as well as patients with incomplete remission or relapse (n=19) showed declining cortisol excretion in night-time urine during follow-up. At the end of follow-up cortisol excretion did not differ between patients with affective disorder and healthy controls. DISCUSSION: Irrespective of residual depressive symptoms, HPA system activity declines after the generally investigated acute depressive episode.
Asunto(s)
Trastorno Depresivo/fisiopatología , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisario/fisiopatología , Sistema Hipófiso-Suprarrenal/fisiopatología , Adulto , Antidepresivos de Segunda Generación/uso terapéutico , Antidepresivos Tricíclicos/uso terapéutico , Ritmo Circadiano , Ciclohexanoles/uso terapéutico , Trastorno Depresivo/tratamiento farmacológico , Trastorno Depresivo/orina , Femenino , Humanos , Hidrocortisona/orina , Masculino , Mianserina/análogos & derivados , Mianserina/uso terapéutico , Persona de Mediana Edad , Mirtazapina , Factores de Tiempo , Clorhidrato de VenlafaxinaAsunto(s)
Antidepresivos de Segunda Generación/uso terapéutico , Antidepresivos Tricíclicos/uso terapéutico , Ciclohexanoles/uso terapéutico , Trastorno Depresivo Mayor/sangre , Trastorno Depresivo Mayor/tratamiento farmacológico , Mianserina/análogos & derivados , Proteínas Plasmáticas de Unión al Retinol/metabolismo , Adulto , Anciano , Antidepresivos de Segunda Generación/efectos adversos , Antidepresivos Tricíclicos/efectos adversos , Estudios Transversales , Ciclohexanoles/efectos adversos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/psicología , Femenino , Humanos , Masculino , Mianserina/efectos adversos , Mianserina/uso terapéutico , Persona de Mediana Edad , Mirtazapina , Clorhidrato de VenlafaxinaRESUMEN
In twelve healthy volunteers given nitroglycerin sublingually (1.6 mg) or epicutaneously (12 mg), venous distensibility was found to be maximal, even at low plasma concentrations (less than 0.2 ng/ml); there was no further change with increasing concentrations. Peripheral arterial resistance, on the other hand, decreased progressively with rising plasma concentrations and no distinct plateau was demonstrable, even at the highest plasma concentration measured (greater than 2.0 ng/ml).