Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T20:42:25.709Z Has data issue: false hasContentIssue false

Are blunted dexamethasone-induced growth hormone responses unique to depression?

Published online by Cambridge University Press:  09 July 2009

Jogin H. Thakore*
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital, London
Timothy G. Dinan
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital, London
*
1Address for correspondence: Dr Jogin H. Thakore Department of Psychological MedicineSt Bartholomew's HospitalLondon EC1A 7BE.

Synopsis

In health, acute administration of glucocorticoids, such as dexamethasone (DEX), leads to growth hormone (GH) secretion. Depression is characterized by blunted DEX/GH responses. In order to determine the specificity of this test for depression we administered 4 mg of oral DEX, to patients with a DSM-III-R diagnosis of depression, schizophrenia, mania and alcohol dependency syndrome. Samples for GH estimation were taken at − 15 min, 0 min, +60 min, +180 min, +240 min and +300 min. GH responses were attenuated to a similar degree in depression and mania. Less marked attenuation was seen in schizophrenia while those with alcohol dependency syndrome had GH responses indistinguishable from normal volunteers. Overall, we conclude that subnormal DEX/GH secretion is not specific to depression.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn – Revised. American Psychiatric Association: Washington, DC.Google Scholar
Andreasen, N. C. (1983). Scale for the Assessment of Negative Symptoms (SANS). University of Iowa Press: Iowa City, Iowa.Google Scholar
Ansseau, M., von Frenckell, R., Cerfontaine, J. L., Papart, P., Franck, G., Timsit-Berthier, M., Geenen, V. & Legros, J. J. (1988). Neuroendocrine evaluation of catecholaminergic neurotransmission in mania. Psychiatry Research 22, 193206.CrossRefGoogle Scholar
Arana, G. W., Workman, R. J., Baldessarini, R. J. (1984). Association between low plasma levels of dexamethasone and elevated levels of cortisol in psychiatric patients given dexamethasone. American Journal of Psychiatry 141, 16191620.Google ScholarPubMed
Carroll, B. J., Curtis, G. C. & Mendels, J. (1976). Cerebrospinal fluid and plasma free cortisol concentrations in depression. Psychological Medicine 6, 235244.CrossRefGoogle ScholarPubMed
Casanueva, F. F., Burguera, B., Tome, M., Lima, L., Tresguerres, J. A. F., Devesa, J. & Dieguez, C. (1988). Depending on the time of administration, dexamethasone potentiates or blocks growth hormone-releasing hormone-induced growth hormone release in man. Neuroendocrinology 47, 4649.CrossRefGoogle ScholarPubMed
Casanueva, F. F., Burguera, B., Murais, C. & Dieguez, C. (1990). Acute administration of corticoids: a new and peculiar stimulus of growth hormone secretion in man. Journal of Clinical Endocrinology and Metabolism 70, 234237.CrossRefGoogle ScholarPubMed
Checkley, S. A., Slade, A. P. & Shur, E. (1981). Growth hormone and other responses to clonidine in patients with endogenous depression. British Journal of Psychiatry 138, 5155.CrossRefGoogle ScholarPubMed
Checkley, S. A., Glass, I. B., Thomson, C., Corn, T. & Robinson, P. (1984). The GH response to clonidine in endogenous as compared with reactive depression. Psychological Medicine 14, 773777.CrossRefGoogle ScholarPubMed
Dash, R. J., England, B. G., Rees Midgley, A. Jr & Niswender, G. D. (1975). A specific, nonchromatographic, radioimmunoassay for human plasma cortisol. Steroids 26, 647661.CrossRefGoogle ScholarPubMed
Dieguez, C., Page, M. D. & Scanlon, M. F. (1988). Growth hormone neuroregulation and its alterations in disease states. Clinical Endocrinology (Oxford) 28, 109143.Google Scholar
Dinan, T. G. & Barry, S. (1990). Responses of growth hormone to disipramine in endogenous and non-endogenous depression. British Journal of Psychiatry 156, 680684.CrossRefGoogle Scholar
Dinan, T. G., Yatham, L., O'Keane, V. & Barry, S. (1991). Blunting of noradrenergic stimulated growth hormone release in mania. American Journal of Psychiatry 148, 936938.Google ScholarPubMed
Dinan, T. G., O'Keane, V. & Thakore, J. H. (1994). Pyridostigmine-induced growth hormone release in mania: focus on the cholinergic/somatostatin system. Clinical Endocrinology 40, 9396.CrossRefGoogle ScholarPubMed
Doran, A. R., Rubinow, D. R., Wolkowitz, O. M., Roy, A., Breier, A. & Pickar, D. (1989). Fluphenazine treatment reduces CSF somatostatin in patients with schizophrenia: correlations with CSF HVA. Biological Psychiatry 25, 431439.CrossRefGoogle ScholarPubMed
Fuxe, K., Cintra, A., Tangelli, S., von Euler, G., Finman, V., B., , Lundgren, K., Aguirre-Gomez, J., Bjelke, B., Zoli, B., Eneroth, P. & Aganti, L. F. (1989). Integration of humoral and neuronal signals in neuroendocrine regulation. Focus on the interaction of glucocorticoids with central neuropeptide and monoamine neurotransmission. In Recent Advances in Basic and Clinical Neuroendcorinology (ed. Casanueva, F. F. and Dieguez, C.), pp. 109126. Exerptica Medica: Amsterdam.Google Scholar
Glass, I. B., Checkley, S. A., Shur, E. & Dawling, S. (1982). The effect of desipramine upon central adrenergic functions in depressed patients. British Journal of Psychiatry 141, 372376.CrossRefGoogle ScholarPubMed
Gupta, S. K., Ritchie, J. C., Widemann, K. & Hoslboer, F. (1992). Modelling the pharmacokinetics and pharmacodynamics in depressed patients. European Journal of Clinical Pharmacology 43, 5155.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Haque, N., Thrasher, K., Werk, E. E., Knowles, H. C. & Sholiton, L. J. (1972). Studies on dexamethasone metabolism in man; effects of diphenylhydantoin. Journal of Clinical Endocrinology 34, 4450.CrossRefGoogle ScholarPubMed
Holsboer-Trachsler, E., Boul, C., Wiedemann, K. & Holsboer, F. (1987). Dexamethasone suppression test in schizophrenic illness: effects of plasma dexamethasone and caffeine. Acta Psychiatrica Scandinavica 75, 608613.CrossRefGoogle ScholarPubMed
Lam, K. S. L., Srivastava, G., Tam, S., Chung, L., Chan, S. & Tang, F. (1993). Dexamethasone decreases somatostatin mRNA levels in the periventricular nucleus of the rat hypothalamus. Neuroendocrinology 53, 2531.Google Scholar
Lesch, K.-P., Laux, G., Pfuller, H., Erb, A. & Beckmann, H. (1987). Growth hormone (GH) response to GH-releasing hormone in depression. Journal of Clinical Endocrinology and Metabolism 65, 12781281.CrossRefGoogle ScholarPubMed
Linkowski, P., Kerkhofs, M., Van Onderbergen, , Hubain, P., Copinschi, G., L'Hermite-Balderiaux, M., Leclercq, R., Brasseur, M., Mendlewicz, J. & Van Cauter, E. (1994). The 24-hour profile of cortisol, prolactin and growth hormone secretion in mania. Archives of General Psychiatry 51, 616624.CrossRefGoogle ScholarPubMed
Majeed, T., Thakore, J., Gray, C., Dinan, T. G. & Behan, P. O. (1995). Dexamethasone-induced growth hormone release before and after metyrapone administration in patients with chronic fatigue syndrome. Journal of the Irish College of Physicians and Surgeons 24, 2023.Google Scholar
Meesters, P., Kerkhofs, M., Charles, G., Deoster, C., Vanderelest, M. & Mendlewicz, J. (1985). Growth hormone release after desipramine in depressive illness. European Archives of Psychiatry and Neurology 235, 140142.CrossRefGoogle ScholarPubMed
Minagawa, K., Kasuya, Y., Baba, S., Knapp, G. & Skelly, J. P. (1986). Identification and quantification of 6β-hydroxy-dexamethasone as a major urinary metabolite of dexamethasone in man. Steroids 45, 175188.CrossRefGoogle Scholar
Mitchell, P. B., Bearn, J. A., Corn, T. H. & Checkley, S. A. (1988). Growth hormone response to clonidine after recovery in patients with endogenous depression. British Journal of Psychiatry 152, 3438.CrossRefGoogle ScholarPubMed
Montgomery, S. M. & Åsberg, M. (1979). A new depression rating scale designed to be more sensitive to change. British Journal of Psychiatry 6, 382389.CrossRefGoogle Scholar
O'Keane, V. & Dinan, T. G. (1992). Pyridostigmine-induced growth hormone responses in healthy and depressed subjects: evidence for cholinergic supersensitivity in depression. Psychological Medicine 22, 5560.CrossRefGoogle ScholarPubMed
Overall, J. E. & Gorham, D. R. (1962). Brief Psychiatric Rating Scale. Psychological Reprints 10, 799812.Google Scholar
Papachristou, D. N., Liu, J.-L. & Patel, Y.-C. (1994). Glucocorticoids regulate somatostatin peptide and steady state messenger ribonucleic acid levels in normal rat tissues and in somatostatin-producing islet tumor cell line (1027B2). Endocrinology 134, 22592266.CrossRefGoogle ScholarPubMed
Petterson, U., Fyro, B. & Sedvall, G. (1973). A new scale for the longitudinal rating of manic states. Acta Psychiatrica Scandinavica 49, 248256.CrossRefGoogle ScholarPubMed
Raiti, S. (1983). The standards for human growth hormone assay. In Evaluation of Growth Hormone Secretion (ed. Laron, Z. and Butenandt, O.), pp. 162169. Karger: Basel.Google Scholar
Reul, J. M. & De Kloet, E. R. (1985). Two receptor systems for corticosterone rat brain: microdistribution and differential occupation. Endocrinology 17, 25052511.CrossRefGoogle Scholar
Ritchie, J. C., Owens, M. J., Mayer, H., Throck Watson, J., Kilts, C. & Carroll, B. J. (1992). Preliminary studies of 6β- hydroxydexamethasone and its importance in the DST. Biological Psychiatry 32, 825833.CrossRefGoogle Scholar
Rubinow, D. R. (1986). Cerebrospinal fluid somatostatin and psychiatric illness. Biological Psychiatry 21, 341365.CrossRefGoogle ScholarPubMed
Rupprecht, R., Kornhuber, J., Wodarz, N., Lugauer, J., Gobel, C., Haack, D., Beck, G., Muller, O.-A., Riederer, P. & Beckmann, H. (1991). Disturbed glucocorticoid receptor autoregulation and corticotropin response to dexamethasone in depressives pretreated with metyrapone. Biological Psychiatry 29, 10991109.CrossRefGoogle ScholarPubMed
Scacchi, M., Invitti, C., Pincelli, A. I., Pandolfi, C., Dubini, A. & Cavagnini, F. (1995). Lack of growth hormone response to acute administration of dexamethasone in anorexia nervosa. European Journal of Endocrinology 132, 152158.CrossRefGoogle ScholarPubMed
Selzer, M. L. (1971). Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. American Journal of Psychiatry 127, 16531658.CrossRefGoogle ScholarPubMed
Silva, C. M., Powell-Oliver, F. E., Jewell, C. M., Madhabananada, S., Allgood, V. E. & Cidlowski, J. A. (1994). Regulation of the human glucocorticoid receptor by long-term and chronic treatment with glucocorticoids. Steroids 59, 436442.CrossRefGoogle Scholar
Statistical Graphics Corporation. (1987). Statgraphics, Version 2.7. SGC: New York.Google Scholar
Stockwell, T., Murphy, D. & Hodgson, R. (1983). The severity of alcohol dependence questionnaire: its use, reliability and validity. British Journal of Addiction 78, 145155.CrossRefGoogle ScholarPubMed
Tamai, H., Komaki, G., Matsubayashi, S., Kobayashi, N., Mori, K., Nakagawa, T., Truong, M. P. M., Walter, R. M. Jr & Kumagi, L. F. (1990). Effect of cholinergic muscarinic receptor blockade on human growth hormone (GH)-releasing hormone-(1–44)-induced GH secretion in anorexia nervosa. Journal of Clinical Endocrinology and Metabolism 70. 738741.CrossRefGoogle Scholar
Tancer, M. E., Stein, M. B., Black, B. & Udhe, T. W. (1993). Blunted growth hormone responses to growth hormone-releasing factor and to clonidine in panic disorder. American Journal of Psychiatry 150, 336337.Google ScholarPubMed
Thakore, J. H. & Dinan, T. G. (1994). Subnormal growth hormone responses to acutely administered dexamethasone in depression. Clinical Endocrinology 40, 623627.CrossRefGoogle ScholarPubMed
Wassef, A., Smith, E. M., Rose, R. M., Gardner, R., Nouyen, H. & Meyer, W. J. (1990). Mononuclear leukocyte glucocorticoid receptor binding characteristics and down-regulation in major depression. Psychoneuroendocrinology 1, 5968.CrossRefGoogle Scholar
Wiedemann, K. & Holsboer, F. (1987). Plasma dexamethasone kinetics during the DST after oral and intravenous administration of the test drug. Biological Psychiatry 22, 13401348.CrossRefGoogle ScholarPubMed
Yehuda, R., Boisoneau, D., Mason, J. W. & Giller, E. L. (1993). Glucocorticoid receptor number and cortisol excretion in mood, anxiety and psychotic disorders. Biological Psychiatry 34, 1825.CrossRefGoogle ScholarPubMed