Pitchot W, Hansenne M, Gonzalez Moreno A, Ansseau M
Psychiatric Unit, CHU du Sart Tilman, Liège, Belgium.
Neuropsychobiology. 1995;32(1):19-22. doi: 10.1159/000119207.
Several lines of evidence suggest a role for dopamine in the pathophysiology of depression. In 1988, we reported a blunted response of growth hormone (GH) to apomorphine, a dopaminergic agonist, in endogenous depression. However, an antidepressant washout period is a major confounding factor in studies assessing the GH response to apomorphine. Indeed, whereas the influence of tricyclic antidepressants on the GH response to apomorphine is presently unknown, several reports have suggested that tricyclics may impair the GH response to clonidine for periods longer than 3 weeks following their discontinuation. In the present study, we hypothesized that a blunted GH response to apomorphine in depressed patients could be related to the recent administration of antidepressants. Therefore, the GH response to apomorphine (0.5 mg) was studied in 11 male DSM-III-R major depressive inpatients who had never received antidepressant therapy (group 1) compared to 11 normal controls and 11 major depressive inpatients drug free for at least 2 weeks (group 2). The three groups differed significantly in the GH peak response to apomorphine: mean (SD) 5.4 (4.0) ng/ml in group 1, 25.5 (10.7) in normal controls, and 5.5 (5.1) in group 2 (F = 15.5, df = 3, 30, p = 0.00001). While group 1 and normal controls (F = 21.8, p = 0.0002) as well as group 2 and controls (F = 5.6, p = 0.03) differed significantly, group 1 and group 2 did not (F = 0.18, p = 0.68). These results suggest that a washout period of 2 weeks could be sufficient in studies assessing the GH response to apomorphine.
多项证据表明多巴胺在抑郁症的病理生理学中发挥作用。1988年，我们报告在内源性抑郁症患者中，生长激素（GH）对多巴胺能激动剂阿扑吗啡的反应迟钝。然而，在评估GH对阿扑吗啡反应的研究中，抗抑郁药洗脱期是一个主要的混杂因素。确实，虽然三环类抗抑郁药对GH对阿扑吗啡反应的影响目前尚不清楚，但有几份报告表明，三环类药物在停药后3周以上可能会损害GH对可乐定的反应。在本研究中，我们假设抑郁症患者中GH对阿扑吗啡反应迟钝可能与近期使用抗抑郁药有关。因此，研究了11名从未接受过抗抑郁治疗的男性DSM-III-R重度抑郁住院患者（第1组）、11名正常对照者和11名至少2周未服用药物的重度抑郁住院患者（第2组）对阿扑吗啡（0.5毫克）的GH反应。三组在GH对阿扑吗啡的峰值反应上有显著差异：第1组平均（标准差）为5.4（4.0）纳克/毫升，正常对照者为25.5（10.7），第2组为5.5（5.1）（F = 15.5，自由度 = 3, 30，p = 0.00001）。虽然第1组与正常对照者（F = 21.8，p = 0.0002）以及第2组与对照者（F = 5.6，p = 0.03）有显著差异，但第1组和第2组没有（F = 0.18，p = 0.68）。这些结果表明，在评估GH对阿扑吗啡反应的研究中，2周的洗脱期可能就足够了。
