Navinés Ricard, Gómez-Gil Esther, Martín-Santos Rocío, de Osaba María J Martínez, Escolar Ginés, Gastó Cristóbal
Institut de Neurociències, Hospital Clínic, Barcelona, Spain.
Hum Psychopharmacol. 2007 Aug;22(6):389-95. doi: 10.1002/hup.862.
It has been suggested that interactions between hypothalamic pituitary adrenal (HPA) axis and serotonin-1A (5-HT(1A)) receptor system are involved in the pathophysiology of major depression. Pharmacologic challenge test with 5-HT(1A) receptor agonists is a useful approach to study the sensitivity of 5-HT(1A) receptors in depressed patients and the interaction of these systems. A cross-sectional case-control study was designed to assess the effect of the 5-HT(1A) receptor agonist, buspirone, on 5-HT(1A) receptor function in 30 patients with major depression (DSM-IV) and in 30 age- and sex-matched healthy controls. Depressed patients showed a basal score in the Hamilton Rating Scale for Depression (HRSD) higher than 17. After the administration of a single oral dose of buspirone (30 mg), corticotrophin (ACTH), cortisol, and prolactin (PRL) peak response minus baseline (Delta) and area under the curve (AUC) were evaluated. No significant difference in the hormonal response between depressed patients and controls was observed. No correlation with the severity of depression (HRSD score) was found. These results indicate no consistent changes in the hormonal response to the 5-HT(1A) agonist buspirone in depressed patients. Therefore, this study does not support the hypothesis of an altered postsynaptic 5-HT(1A) receptor function in major depression.
有人提出,下丘脑-垂体-肾上腺(HPA)轴与5-羟色胺-1A(5-HT(1A))受体系统之间的相互作用参与了重度抑郁症的病理生理学过程。使用5-HT(1A)受体激动剂进行药理激发试验是研究抑郁症患者5-HT(1A)受体敏感性以及这些系统相互作用的一种有用方法。一项横断面病例对照研究旨在评估5-HT(1A)受体激动剂丁螺环酮对30例重度抑郁症(DSM-IV)患者及30例年龄和性别匹配的健康对照者5-HT(1A)受体功能的影响。抑郁症患者在汉密尔顿抑郁量表(HRSD)上的基础评分高于17分。在单次口服丁螺环酮(30毫克)后,评估促肾上腺皮质激素(ACTH)、皮质醇和催乳素(PRL)的峰值反应减去基线值(Δ)以及曲线下面积(AUC)。未观察到抑郁症患者与对照组在激素反应上有显著差异。未发现与抑郁严重程度(HRSD评分)存在相关性。这些结果表明,抑郁症患者对5-HT(1A)激动剂丁螺环酮的激素反应没有一致的变化。因此,本研究不支持重度抑郁症中突触后5-HT(1A)受体功能改变的假说。