Thyroid function and response to 48-hour sleep deprivation in treatment-resistant depressed patients.
BACKGROUND
Clinical depression is associated with abnormalities of the hypothalamic-pituitary-thyroid axis. Changes in thyroid function during sleep deprivation may be related to its antidepressant effects.


METHODS
Levels of thyroid-stimulating hormone, tri-iodothyronine, tri-iodothyronine uptake, thyroxine, and free thyroxine were measured before, during, and after a 48-hour sleep deprivation in nine treatment-resistant depressed patients. Clinical state was assessed every 4 hours. A retrospective study of 26 similar patients was added for cross-validation.


RESULTS
Significant increases in thyroid-stimulating hormone and tri-iodothyronine during sleep deprivation were not correlated with clinical improvement. Sleep deprivation responders had lower tri-iodothyronine uptake levels than nonresponders in both the prospective (p <.02) and the retrospective (p <.03) samples.


CONCLUSIONS
The lower tri-iodothyronine uptake values in responders may identify a subgroup of depressed patients who respond to sleep deprivation by virtue of some abnormality of the hypothalamic-pituitary-thyroid axis that is temporarily corrected by sleep deprivation.
David
M M
MM
Department of Psychiatry, Queen's University and Kingston Psychiatric Hospital, and School of Medicine, Queen's University (EW), Kingston, Canada.
Owen
J A
JA
Abraham
G
G
Delva
N J
NJ
Southmayd
S E
SE
Wooltorton
E
E
Lawson
J S
JS
D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012892:Sleep Deprivation / Q000523:psychology*; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood; D013997:Time Factors; D017211:Treatment Failure
D013963:Thyroid Hormones