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Effects of selective serotonin reuptake inhibitor treatment on plasma oxytocin and cortisol in major depressive disorder.

Keating C, Dawood T, Barton DA, Lambert GW, Tilbrook AJ - BMC Psychiatry (2013)

Bottom Line: Previous research has investigated potential correlations between oxytocin and symptoms of MDD, including a link between oxytocin and treatment related symptom reduction.These outcomes demonstrate that symptoms of MDD were reduced following effective treatment with an SSRI, and further, stress physiology was unlikely to be a key factor in this outcome.Further research is required to discriminate potential differences in underlying stress physiology for individuals with MDD who respond to antidepressant treatment, relative to those who experience treatment resistance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred, Melbourne, Australia. ckeating@swin.edu.au

ABSTRACT

Background: Oxytocin is known for its capacity to facilitate social bonding, reduce anxiety and for its actions on the stress hypothalamopituitary adrenal (HPA) axis. Since oxytocin can physiologically suppress activity of the HPA axis, clinical applications of this neuropeptide have been proposed in conditions where the function of the HPA axis is dysregulated. One such condition is major depressive disorder (MDD). Dysregulation of the HPA system is the most prominent endocrine change seen with MDD, and normalizing the HPA axis is one of the major targets of recent treatments. The potential clinical application of oxytocin in MDD requires improved understanding of its relationship to the symptoms and underlying pathophysiology of MDD. Previous research has investigated potential correlations between oxytocin and symptoms of MDD, including a link between oxytocin and treatment related symptom reduction. The outcomes of studies investigating whether antidepressive treatment (pharmacological and non-pharmacological) influences oxytocin concentrations in MDD, have produced conflicting outcomes. These outcomes suggest the need for an investigation of the influence of a single treatment class on oxytocin concentrations, to determine whether there is a relationship between oxytocin, the HPA axis (e.g., oxytocin and cortisol) and MDD. Our objective was to measure oxytocin and cortisol in patients with MDD before and following treatment with selective serotonin reuptake inhibitors, SSRI.

Method: We sampled blood from arterial plasma. Patients with MDD were studied at the same time twice; pre- and post- 12 weeks treatment, in an unblinded sequential design (clinicaltrials.govNCT00168493).

Results: Results did not reveal differences in oxytocin or cortisol concentrations before relative to following SSRI treatment, and there were no significant relationships between oxytocin and cortisol, or these two physiological variables and psychological symptom scores, before or after treatment.

Conclusions: These outcomes demonstrate that symptoms of MDD were reduced following effective treatment with an SSRI, and further, stress physiology was unlikely to be a key factor in this outcome. Further research is required to discriminate potential differences in underlying stress physiology for individuals with MDD who respond to antidepressant treatment, relative to those who experience treatment resistance.

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HAM-D scores in patients with MDD, untreated and following SSRI treatment.
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Figure 1: HAM-D scores in patients with MDD, untreated and following SSRI treatment.

Mentions: Patients with MDD were moderately depressed with a mean (±SEM) HAM-D score of 25.1 ± 1.0 and BDI score of 28.8 ± 1.7. They also had high levels of trait anxiety with a mean (±SEM) 62.1 ± 1.8 and of state anxiety 56.8 ± 2.9. Following therapy, patients showed a 50% reduction (or more) in clinical symptoms (mean ± SEM): HAM-D 6.6 ± 1.2 (Figure 1) and BDI 8.9 ± 1.4 and demonstrated moderate to high anxiety symptoms (mean ± SEM): trait anxiety 44.9 ± 3.1 and state anxiety 38.2 ± 2.5.


Effects of selective serotonin reuptake inhibitor treatment on plasma oxytocin and cortisol in major depressive disorder.

Keating C, Dawood T, Barton DA, Lambert GW, Tilbrook AJ - BMC Psychiatry (2013)

HAM-D scores in patients with MDD, untreated and following SSRI treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643878&req=5

Figure 1: HAM-D scores in patients with MDD, untreated and following SSRI treatment.
Mentions: Patients with MDD were moderately depressed with a mean (±SEM) HAM-D score of 25.1 ± 1.0 and BDI score of 28.8 ± 1.7. They also had high levels of trait anxiety with a mean (±SEM) 62.1 ± 1.8 and of state anxiety 56.8 ± 2.9. Following therapy, patients showed a 50% reduction (or more) in clinical symptoms (mean ± SEM): HAM-D 6.6 ± 1.2 (Figure 1) and BDI 8.9 ± 1.4 and demonstrated moderate to high anxiety symptoms (mean ± SEM): trait anxiety 44.9 ± 3.1 and state anxiety 38.2 ± 2.5.

Bottom Line: Previous research has investigated potential correlations between oxytocin and symptoms of MDD, including a link between oxytocin and treatment related symptom reduction.These outcomes demonstrate that symptoms of MDD were reduced following effective treatment with an SSRI, and further, stress physiology was unlikely to be a key factor in this outcome.Further research is required to discriminate potential differences in underlying stress physiology for individuals with MDD who respond to antidepressant treatment, relative to those who experience treatment resistance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred, Melbourne, Australia. ckeating@swin.edu.au

ABSTRACT

Background: Oxytocin is known for its capacity to facilitate social bonding, reduce anxiety and for its actions on the stress hypothalamopituitary adrenal (HPA) axis. Since oxytocin can physiologically suppress activity of the HPA axis, clinical applications of this neuropeptide have been proposed in conditions where the function of the HPA axis is dysregulated. One such condition is major depressive disorder (MDD). Dysregulation of the HPA system is the most prominent endocrine change seen with MDD, and normalizing the HPA axis is one of the major targets of recent treatments. The potential clinical application of oxytocin in MDD requires improved understanding of its relationship to the symptoms and underlying pathophysiology of MDD. Previous research has investigated potential correlations between oxytocin and symptoms of MDD, including a link between oxytocin and treatment related symptom reduction. The outcomes of studies investigating whether antidepressive treatment (pharmacological and non-pharmacological) influences oxytocin concentrations in MDD, have produced conflicting outcomes. These outcomes suggest the need for an investigation of the influence of a single treatment class on oxytocin concentrations, to determine whether there is a relationship between oxytocin, the HPA axis (e.g., oxytocin and cortisol) and MDD. Our objective was to measure oxytocin and cortisol in patients with MDD before and following treatment with selective serotonin reuptake inhibitors, SSRI.

Method: We sampled blood from arterial plasma. Patients with MDD were studied at the same time twice; pre- and post- 12 weeks treatment, in an unblinded sequential design (clinicaltrials.govNCT00168493).

Results: Results did not reveal differences in oxytocin or cortisol concentrations before relative to following SSRI treatment, and there were no significant relationships between oxytocin and cortisol, or these two physiological variables and psychological symptom scores, before or after treatment.

Conclusions: These outcomes demonstrate that symptoms of MDD were reduced following effective treatment with an SSRI, and further, stress physiology was unlikely to be a key factor in this outcome. Further research is required to discriminate potential differences in underlying stress physiology for individuals with MDD who respond to antidepressant treatment, relative to those who experience treatment resistance.

Show MeSH
Related in: MedlinePlus