Nerozzi D, Graziosi S, Melia E, Aceti F, Magnani A, Fiume S, Fraioli F, Frajese G
Psychiatry Res. 1987 Mar;20(3):207-13. doi: 10.1016/0165-1781(87)90080-1.
Electroconvulsive therapy (ECT) is often efficacious in severe depression, and it is occasionally used in the treatment of schizophrenia. The mechanism of action of ECT is still poorly understood. We evaluated thyroid-stimulating hormone (TSH) and prolactin responses to thyrotropin-releasing hormone (TRH) after a first ECT and at the end of a series of seven ECTs in eight unipolar depressed patients with blunted basal TSH/TRH response, eight unipolar depressed patients with normal TSH/TRH response, and eight schizophrenic patients. The hormone patterns obtained after the first ECT showed an increase in prolactin and a decrease in TSH in all groups of patients, suggesting a nonspecific response. At the end of the therapeutic course, TSH responses increased in both groups of depressed patients, and the elevation was more relevant in depressed patients with normal TSH/TRH. Our data suggest that the mechanism of action of ECT becomes more specific when it is performed chronically and differs according to the organic substrate underlying different mental disorders. Moreover, an aminergic activation in the two groups of depressed patients seems to take place.
电休克疗法（ECT）在重度抑郁症中通常有效，偶尔也用于治疗精神分裂症。ECT的作用机制仍知之甚少。我们评估了8例基础促甲状腺激素/促甲状腺激素释放激素（TSH/TRH）反应迟钝的单相抑郁症患者、8例TSH/TRH反应正常的单相抑郁症患者和8例精神分裂症患者在首次ECT后以及7次ECT疗程结束时，促甲状腺激素（TSH）和催乳素对促甲状腺激素释放激素（TRH）的反应。首次ECT后获得的激素模式显示，所有患者组中催乳素增加，TSH降低，提示存在非特异性反应。在治疗疗程结束时，两组抑郁症患者的TSH反应均增加，且在TSH/TRH正常的抑郁症患者中升高更为明显。我们的数据表明，ECT长期进行时其作用机制变得更具特异性，并且因不同精神障碍潜在的器质性基础而异。此外，两组抑郁症患者似乎都发生了胺能激活。
