title: Effects of intrathecal thyrotropin-releasing hormone (protirelin) in refractory depressed patients.
abstract: 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.
authors.affiliation: Biological Psychiatry Branch, National Institutes of Mental Health, Bethesda, Md, USA.
authors.forename: L B
authors.initials: LB
authors.lastname: Marangell
authors.forename: M S
authors.initials: MS
authors.lastname: George
authors.forename: A M
authors.initials: AM
authors.lastname: Callahan
authors.forename: T A
authors.initials: TA
authors.lastname: Ketter
authors.forename: P J
authors.initials: PJ
authors.lastname: Pazzaglia
authors.forename: T A
authors.initials: TA
authors.lastname: L'Herrou
authors.forename: G S
authors.initials: GS
authors.lastname: Leverich
authors.forename: R M
authors.initials: RM
authors.lastname: Post
mesh_terms: 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
chemical_list: D013973:Thyrotropin-Releasing Hormone