Effects of intrathecal thyrotropin-releasing hormone (protirelin) in refractory depressed patients.
BACKGROUND
Therapeutic effects of the tripeptide protirelin (thyrotropin-releasing hormone) have been postulated in the affective disorders, but direct assessment in humans has been hindered by poor blood-brain barrier permeability.


METHODS
Eight medication-free inpatients with refractory depression received 500 micrograms of protirelin via a lumbar intrathecal injection and an identical sham lumbar puncture procedure, separated by 1 week, in a double-blind crossover design.


RESULTS
Five of eight patients responded to intrathecal protirelin, defined as a 50% or greater reduction in an abbreviated Hamilton Rating Scale for Depression score. Suicidality also was reduced significantly (P < .05). Responses were rapid and clinically robust, but short-lived.


CONCLUSIONS
Administration of protirelin by an intrathecal route induced a rapid improvement in mood and suicidality in these refractory depressed patients, supporting the hypothesis that thyrotropin-releasing hormone could be a positive modulator of mood.
Marangell
L B
LB
Biological Psychiatry Branch, National Institutes of Mental Health, Bethesda, Md, USA.
George
M S
MS
Callahan
A M
AM
Ketter
T A
TA
Pazzaglia
P J
PJ
L'Herrou
T A
TA
Leverich
G S
GS
Post
R M
RM
D000339:Affect / Q000187:drug effects; D018592:Cross-Over Studies; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006760:Hospitalization; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D013973:Thyrotropin-Releasing Hormone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D013973:Thyrotropin-Releasing Hormone