Changes in the hypothalamic-pituitary-adrenal axis and leptin levels during antidepressant treatment.
BACKGROUND
In depressed patients, overstimulation of the hypothalamo-pituitary-adrenocortical (HPA) system, probably caused by glucocorticoid receptor resistance, is the most consistent neurobiological finding. Glucocorticoids themselves are reported to increase leptin synthesis and secretion in humans.


METHODS
We examined alterations in plasma levels of leptin as well as changes in the HPA system function using the combined dexamethasone/corticotropin-releasing hormone (dex/CRH) test on admission and at discharge in 74 depressed inpatients.


RESULTS
Mean leptin concentration did not change significantly between admission and discharge. However, changes in ACTH response and partial cortisol response to the combined dex/CRH test between admission and discharge were significantly correlated with leptin levels at discharge.


CONCLUSIONS
Leptin levels at discharge rise as the HPA axis normalizes. These findings may be explained by an improvement in glucocorticoid receptor sensitivity among depressed patients during antidepressant therapy and a consecutively increased influence of glucocorticoids on leptin levels via the glucocorticoid receptor.
Himmerich
Hubertus
H
Max-Planck-Institut fur Psychiatrie, Munchen, Deutschland. himmeric@med.uni-marburg.de
Zimmermann
Petra
P
Ising
Marcus
M
Kloiber
Stefan
S
Lucae
Susanne
S
Kunzel
Heike E
HE
Binder
Elisabeth B
EB
Holsboer
Florian
F
Uhr
Manfred
M
D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D019540:Area Under Curve; D003346:Corticotropin-Releasing Hormone / Q000187:drug effects; D003866:Depressive Disorder / Q000188:drug therapy / Q000378:metabolism*; D003907:Dexamethasone; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects*
D000928:Antidepressive Agents; D020738:Leptin; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone