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Rainer Rupprecht - One of the best experts on this subject based on the ideXlab platform.
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The influence of 4–week treatment with sertraline on the combined T3/TRH Test in depressed patients
European Archives of Psychiatry and Clinical Neuroscience, 2005Co-Authors: Cornelius Schüle, Thomas C. Baghai, Peter Zwanzger, Daniela Eser, Ludwig Schaaf, L. Alajbegovic, M. Schwarz, H.-j. Möller, Rainer RupprechtAbstract:In the present study, the influence of a 4–week treatment with sertraline on the regulation of hypothalamic–pituitary–thyroid (HPT) axis activity in depression was investigated, in particular the impact of sertraline on the thyroid receptor (TR)–mediated negative feedback control as measured by the combined T3/TRH Test. In 20 drug–free patients (8 men,12 women) suffering from a major depressive episode according to DSM-IV criteria the single TRH–Stimulation Test (administration of 200 µg TRH at 09:00h) was carried out followed by a combined T3/TRH Test (pre–treatment with 40 µg 3,5,3’–triiodothyronine [T3] the night before; administration of 200 µg TRH at 09:00h the next day). After 4 weeks of treatment with sertraline at a standard dosage of 50 mg/day, both the single TRH Test and the combined T3/TRH Test were repeated in the depressed patients. Using repeated–measures ANOVA for statistical analysis, antidepressant therapy with sertraline did not have any significant impact on the TRH–induced TSH and prolactin Stimulation (ΔTSH, ΔPRL) during the single TRH Test nor during the combined T3/TRH Test, neither in responders (n = 10) nor in non–responders (n = 10). Moreover, the percentage suppression of TRH–induced TSH Stimulation (ΔTSH) after pre–treatment with 40 µg T3 was comparable before (–61.07 %) and after the 4–week treatment with sertraline (–58.92 %). Apparently, the therapeutic efficacy of antidepressants such as sertraline is not related to the regulation of HPT axis activity in depressed patients.
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The combined T3/TRH Test in depressed patients and healthy controls
Psychoneuroendocrinology, 2004Co-Authors: Cornelius Schüle, Thomas C. Baghai, Vassiliki Tsikolata, Peter Zwanzger, Daniela Eser, Ludwig Schaaf, Rainer RupprechtAbstract:Summary It is well established that depressed patients show a blunted TSH response in the TRH-Stimulation Test. However, it has not been investigated so far whether pre-treatment with 3,5,3′-triiodothyronine (T3) is able to further suppress the TRH-induced TSH response in depressed patients or whether it may cause an escape-phenomenon with paradoxically enhanced TSH Stimulation in a subsequent TRH Test. In 20 drug-free depressed patients (eight men, 12 women) suffering from a major depressive episode according to DSM-IV criteria and in 20 age- and sex-matched healthy controls, the single TRH-Stimulation Test (administration of 200 μg TRH at 09:00 h) was carried out followed by a combined T3/TRH Test (pre-treatment with 40 μg T3 at 23:00 h the night before; administration of 200 μg TRH at 09:00 h the next day). Compared to the controls, the depressed patients showed a significantly blunted TSH response in the single TRH Test. However, the percentage suppression of TRH-induced TSH Stimulation after pre-treatment with 40 μg T3 was comparable in the depressive patients (61.07%) and the healthy volunteers (64.20%). Prolactin secretion did not differ between patients and controls either in the single TRH Test or in the combined T3/TRH Test. Apparently, in contrast to the hypothalamo-pituitary–adrenocortical (HPA) system, no disturbance of feedback control in regulation of the hypothalamo-pituitary–thyroid (HPT) axis secretion can be demonstrated in depressed patients when using the combined T3/TRH Test.
Fahrettin Kelestimur - One of the best experts on this subject based on the ideXlab platform.
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Do we still need the TRH Stimulation Test
Thyroid, 2007Co-Authors: Hulusi Atmaca, Fatih Tanriverdi, Cumali Gokce, Kursad Unluhizarci, Fahrettin KelestimurAbstract:Objective: To evaluate the diagnostic value of the thyrotropin-releasing hormone (TRH) Stimulation Test in the diagnosis of central hypothyroidism in patients with Sheehan's syndrome. Design: TRH Stimulation Test was performed in 72 patients with Sheehan's syndrome. Basal free triiodothyronine (fT3) and free thyroxine (fT4) levels were measured. Serum thyrotropin (TSH) concentration was determined before and 30, 60, 90, and 120 minutes after 200 μg TRH IV bolus injection. The peak TSH values
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do we still need the TRH Stimulation Test
Thyroid, 2007Co-Authors: Hulusi Atmaca, Fatih Tanriverdi, Cumali Gokce, Kursad Unluhizarci, Fahrettin KelestimurAbstract:Objective: To evaluate the diagnostic value of the thyrotropin-releasing hormone (TRH) Stimulation Test in the diagnosis of central hypothyroidism in patients with Sheehan's syndrome. Design: TRH s...
Patricia Diaz-guardiola - One of the best experts on this subject based on the ideXlab platform.
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Isolated idiopathic central hypothyroidism in an adult, possibly caused by Thyrotropin Releasing Hormone (TRH) deficiency
Hormones, 2010Co-Authors: Alma Prieto-tenreiro, Patricia Diaz-guardiolaAbstract:Central Hypothyroidism (Central H) is mainly due to acquired lesions, either in the pituitary, the hypothalamus or both, and in such cases it is usually associated with deficient secretion of other pituitary hormones. Isolated central hypothyroidism (I Central H) remains a very rare disease. By the use of the serum Thyroid Stimulating Hormone (TSH) assay as an initial screening Test for thyroid disease, the diagnosis of I, Central H can be missed or delayed, since most of these patients have normal or even slightly high serum TSH concentrations. We present a 54-year-old woman with intense tiredness, in whom hypothyroidism was initially and persistently excluded because of normal TSH levels. Further investigations showed again a normal TSH with slightly low Free Thyroxine (FT4), and Central H was suspected. A Thyrotropin Releasing Hormone (TRH) Stimulation Test confirmed the diagnosis. No lesion was found by Magnetic Resonance Imaging (MRI). No other pituitary hormone insufficiency was detected. Finally, after excluding, the intake of any drug affecting the hypothalamo-pituitary-thyroid axis and the presence of critical systemic illness, the unusual diagnosis of idiopathic isolated Central H was made. When suspecting Central H, both FT4 and TSH should be measured and if these values are low, TSH response to TRH is recommended to reach specific diagnosis.
Cornelius Schüle - One of the best experts on this subject based on the ideXlab platform.
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The influence of 4–week treatment with sertraline on the combined T3/TRH Test in depressed patients
European Archives of Psychiatry and Clinical Neuroscience, 2005Co-Authors: Cornelius Schüle, Thomas C. Baghai, Peter Zwanzger, Daniela Eser, Ludwig Schaaf, L. Alajbegovic, M. Schwarz, H.-j. Möller, Rainer RupprechtAbstract:In the present study, the influence of a 4–week treatment with sertraline on the regulation of hypothalamic–pituitary–thyroid (HPT) axis activity in depression was investigated, in particular the impact of sertraline on the thyroid receptor (TR)–mediated negative feedback control as measured by the combined T3/TRH Test. In 20 drug–free patients (8 men,12 women) suffering from a major depressive episode according to DSM-IV criteria the single TRH–Stimulation Test (administration of 200 µg TRH at 09:00h) was carried out followed by a combined T3/TRH Test (pre–treatment with 40 µg 3,5,3’–triiodothyronine [T3] the night before; administration of 200 µg TRH at 09:00h the next day). After 4 weeks of treatment with sertraline at a standard dosage of 50 mg/day, both the single TRH Test and the combined T3/TRH Test were repeated in the depressed patients. Using repeated–measures ANOVA for statistical analysis, antidepressant therapy with sertraline did not have any significant impact on the TRH–induced TSH and prolactin Stimulation (ΔTSH, ΔPRL) during the single TRH Test nor during the combined T3/TRH Test, neither in responders (n = 10) nor in non–responders (n = 10). Moreover, the percentage suppression of TRH–induced TSH Stimulation (ΔTSH) after pre–treatment with 40 µg T3 was comparable before (–61.07 %) and after the 4–week treatment with sertraline (–58.92 %). Apparently, the therapeutic efficacy of antidepressants such as sertraline is not related to the regulation of HPT axis activity in depressed patients.
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The combined T3/TRH Test in depressed patients and healthy controls
Psychoneuroendocrinology, 2004Co-Authors: Cornelius Schüle, Thomas C. Baghai, Vassiliki Tsikolata, Peter Zwanzger, Daniela Eser, Ludwig Schaaf, Rainer RupprechtAbstract:Summary It is well established that depressed patients show a blunted TSH response in the TRH-Stimulation Test. However, it has not been investigated so far whether pre-treatment with 3,5,3′-triiodothyronine (T3) is able to further suppress the TRH-induced TSH response in depressed patients or whether it may cause an escape-phenomenon with paradoxically enhanced TSH Stimulation in a subsequent TRH Test. In 20 drug-free depressed patients (eight men, 12 women) suffering from a major depressive episode according to DSM-IV criteria and in 20 age- and sex-matched healthy controls, the single TRH-Stimulation Test (administration of 200 μg TRH at 09:00 h) was carried out followed by a combined T3/TRH Test (pre-treatment with 40 μg T3 at 23:00 h the night before; administration of 200 μg TRH at 09:00 h the next day). Compared to the controls, the depressed patients showed a significantly blunted TSH response in the single TRH Test. However, the percentage suppression of TRH-induced TSH Stimulation after pre-treatment with 40 μg T3 was comparable in the depressive patients (61.07%) and the healthy volunteers (64.20%). Prolactin secretion did not differ between patients and controls either in the single TRH Test or in the combined T3/TRH Test. Apparently, in contrast to the hypothalamo-pituitary–adrenocortical (HPA) system, no disturbance of feedback control in regulation of the hypothalamo-pituitary–thyroid (HPT) axis secretion can be demonstrated in depressed patients when using the combined T3/TRH Test.
Mady Hornigrohan - One of the best experts on this subject based on the ideXlab platform.
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TRH Stimulation Test as a predictor of acute and long term antidepressant response in major depression
Journal of Affective Disorders, 1996Co-Authors: Jay D Amsterdam, Maurizio Fava, Greg Maislin, Jerrold F Rosenbaum, Mady HornigrohanAbstract:Abstract We assessed the prognostic utility of the TRH Stimulation Test by examining 1. (a) the relationship between pre-treatment ΔTSH and acute response to fluoxetine treatment, and 2. (b) the relationship between the change in ΔTSH (ΔΔTSH value) after repeated TRH Testing at 6 weeks of fluoxetine treatment and long-term outcome during maintenance fluoxetine or placebo therapy. 43 MDD patients were studied with sequential TRH Tests at 6-week intervals. Fluoxetine ‘responders’ were defined as patients with a Hamilton Depression Rating Scale score ≤ 7 by week 9 of treatment and who remained in remission at least 3 additional weeks. These subjects were then randomized to one of four fluoxetine/placebo treatment groups and long-term outcome assessed. Overall, there was no difference in the mean pre-treatment ΔTSH values between acute fluoxetine responders and nonresponders. Moreover, we observed similar ΔΔTSH values in patients who maintained long-term remission compared to those who relapsed during maintenance with either fluoxetine or placebo. In contrast to prior reports of an higher ΔΔTSH value in long-term remitters, the present observation of similar mean ΔΔTSH values patients with long-term remission compared to those who relapsed suggest a limited prognostic utility for the TRH Stimulation Test in MDD.
