title: Impact of the selective serotonin reuptake inhibitor citalopram on insulin sensitivity, leptin and basal cortisol secretion in depressed and non-depressed euglycemic women of reproductive age.
abstract: BACKGROUND
  Major depression in women of reproductive age may be accompanied by multiple endocrine and metabolic disturbances, which, in turn, may affect reproductive functioning. Enhanced cortisol synthesis, impaired leptin production and diminished insulin sensitivity have been reported in some depressed populations. We sought to determine whether an 8-week administration of citalopram would have an effect on these endocrine factors in a group of euglycemic depressed and non-depressed women of reproductive age.
  
  
  METHODS
  Fourteen depressed and 18 non-depressed women (diagnosed by structured clinical interview) aged between 18 and 45 years completed an 8-week study. All depressed women were treated with citalopram and non-depressed subjects randomized to citalopram or no treatment in an open label cohort study. An oral glucose tolerance test with insulin levels was performed at baseline and at the end of the 8-week trial. Weight, blood pressure, fasting serum cortisol, fasting serum leptin and Beck Depression Inventory were assessed at baseline, 2, 4 and 8 weeks.
  
  
  RESULTS
  Citalopram significantly improved depressive symptoms and Beck Depression Inventory scores in the depressed cohort. Cortisol production was higher in depressed women but did not diminish with citalopram therapy over 8 weeks. Indices of insulin sensitivity and leptin production were similar between depressed and non-depressed women and did not change despite citalopram therapy.
  
  
  CONCLUSIONS
  . Insulin sensitivity in moderately depressed women of reproductive age does not differ from that in a similar group of non-depressed women. Insulin sensitivity, cortisol secretion and leptin production do not change significantly in depressed women following an 8-week course of citalopram despite substantial improvement in depression scores.
authors.affiliation: Department of Obstetrics and Gynecology, Texas Tech University Health Science Center, Amarillo, Texas 79106, USA. robert.kauffman@ttuhsc.edu
authors.forename: Robert P
authors.initials: RP
authors.lastname: Kauffman
authors.forename: V Daniel
authors.initials: VD
authors.lastname: Castracane
authors.forename: Debie L
authors.initials: DL
authors.lastname: White
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Baldock
authors.forename: Ron
authors.initials: R
authors.lastname: Owens
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D015283:Citalopram / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015283:Citalopram; D006854:Hydrocortisone; D007328:Insulin; D020738:Leptin; D017367:Selective Serotonin Reuptake Inhibitors