[Acute and chronic effects of electroconvulsive therapy on neuroactive steroids in patients with major depressive disorder].
OBJECTIVE
Baseline serum levels of neuroactive steroids such as dehydroepiandrosterone sulfate (DHEAS), 17-hydroxyprogesterone (17-OHP), testosterone, and cortisol were measured, and the acute and long-term effects of electroconvulsive therapy (ECT) on these hormones and the effect of gender on alterations in steroid hormones were investigated in patients with major depressive disorder (MDD).


METHODS
The study included 25 inpatients (11 male, 14 female) diagnosed with MDD that responded to ECT, and 37 healthy controls (17 male, 20 female). Serum levels of cortisol, DHEAS, 17-OHP, and testosterone were measured 2 days before and 10 min after the first ECT, and 3 days after the last ECT in the patients. These measurements were obtained only once in the controls.


RESULTS
Basal DHEAS increased, testosterone and 17-OHP decreased, and cortisol levels remained unchanged in MDD patients as compared to the controls. After completion of the therapeutic course of ECT, DHEAS levels in the patients were higher than they were before the treatment. After ECT treatment, cortisol and 17-OHP levels in the patients were lower than those in the controls; however, testosterone levels did not differ between the groups. In the MDD patients, increases in DHEAS and decreases in testosterone were only observed in men, while decreases in 17-OHP were only seen in women.


CONCLUSIONS
Alterations were observed in some neuroactive steroids in MDD patients and it appears that ECT affected these hormones. It is not clear whether the observed alterations in neuroactive steroids are associated with the pathophysiology of depression or whether they play a role in the therapeutic effects of ECT.
Ozsoy
Saliha
S
Erciyes U Tip Fak., Psikiyatri AD. sozsoy@erciyes.edu.tr
Eşel
Ertuğrul
E
Hacimusalar
Yunus
Y
Candan
Zaliha
Z
Kula
Mustafa
M
Turan
Tayfun
T
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000328:Adult; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D003865:Major Depressive Disorder / Q000097:blood / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome
D013256:Steroids; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone