title: Relationships between thyroid hormone and antidepressant responses to total sleep deprivation in mood disorder patients.
abstract: BACKGROUND
  Acute transient antidepressant effects of sleep deprivation are consistently observed in 50% of depressed patients, but the mechanisms of these, at times, dramatic improvements in mood have not been adequately elucidated. Some, but not all, studies suggest a relationship to increased thyroid-stimulating hormone (TSH) secretion.
  
  
  METHODS
  TSH and other thyroid indices were measured at 8:00 AM after a baseline night's sleep and at 8:00 AM following a night of total sleep deprivation (S.D.) in 34 medication-free, affective disorder patients assessed with Hamilton, Beck, and Bunney-Hamburg depression ratings as well as two hourly self-ratings on a visual analog scale.
  
  
  RESULTS
  Compared with baseline, S.D. induced highly significant increases in TSH, levothyroxine, free levothyroxine, and triiodothyronine. The 12 S.D. responders tended to have greater TSH increases than the 15 nonresponders (p < .10). The change in Beck depression ratings significantly correlated with the change in TSH (r = -.40, p = .0496, n = 24).
  
  
  CONCLUSIONS
  These data are consistent with several other reports of a significant relationship between degree of antidepressant response to S.D. and increases in TSH measured at 8:00 AM near their usual nadir. Acute removal of the sleep-related break on the hypothalamic-pituitary-thyroid axis remains a promising candidate for the mechanism of sleep deprivation-induced improvement in mood in depressed patients.
authors.affiliation: Biological Psychiatry Branch, NIMH, NIH, Bethesda, Maryland, Biological Psychiatry Branch, NIMH 20892-1272, USA.
authors.forename: P I
authors.initials: PI
authors.lastname: Parekh
authors.forename: T A
authors.initials: TA
authors.lastname: Ketter
authors.forename: L
authors.initials: L
authors.lastname: Altshuler
authors.forename: M A
authors.initials: MA
authors.lastname: Frye
authors.forename: A
authors.initials: A
authors.lastname: Callahan
authors.forename: L
authors.initials: L
authors.lastname: Marangell
authors.forename: R M
authors.initials: RM
authors.lastname: Post
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000097:blood* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000097:blood* / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012892:Sleep Deprivation; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D013963:Thyroid Hormones; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine