Neuroendocrine dysfunction and response to tricyclic antidepressants.
Patients with DSM-III unipolar major depression (N = 26) were treated with tricyclic antidepressants after 2 weeks of inpatient drug-free observation and neuroendocrine testing. Medication was prescribed with individualized dosages and was monitored with blood levels. Treatment response (greater than or equal to 50% decrease in Hamilton depression score after 4 weeks) was seen in 6 of 13 patients given desipramine and 7 of 13 given nortriptyline. Of the 13 nonresponders, 9 accepted treatment with another drug and/or ECT; 5 responded. Thus, 18 of the 26 patients responded to treatment. Abnormal pretreatment DST was correlated with increased responsiveness to treatment, although all patients had a high probability of response.
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D003891:Desipramine / Q000627:therapeutic use; D003907:Dexamethasone; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone
D000929:Antidepressive Agents, Tricyclic; D013973:Thyrotropin-Releasing Hormone; D003907:Dexamethasone; D013972:Thyrotropin; D009661:Nortriptyline; D003891:Desipramine; D006854:Hydrocortisone