Plasma concentrations of neuroactive steroids before and after repetitive transcranial magnetic stimulation (rTMS) in major depression

Frank Padberg, Flavia Di Michele, Peter Zwanzger, Elena Romeo, Giorgio Bernardi, Cornelius Schüle, Thomas C. Baghai, Robin Ella, Augusto Pasini, Rainer Rupprecht

Research output: Contribution to journalArticlepeer-review


There is evidence for altered levels of neuroactive steroids in major depression that normalize after successful antidepressant pharmacotherapy. Currently it is not known whether this is a general principle of clinically effective antidepressant therapy or a pharmacological effect of antidepressants. Here, we investigated whether repetitive transcranial magnetic stimulation (rTMS) may affect plasma concentrations of neuroactive steroids in a similar way as antidepressant pharmacotherapy. Progesterone, 3α,5α-tetrahydroprogesterone (3α,5α-THP), 3α,5β- tetrahydroprogesterone (3α,5β-THP), 3β,5α-tetrahydroprogesterone (3β, 5α-THP) and dehydroepiandrosterone (DHEA) were quantified in 37 medication-free patients suffering from a major depressive episode before and after 10 sessions of left prefrontal rTMS. Plasma samples were analyzed by means of a highly sensitive and specific combined gas chromatography/mass spectrometry analysis. There was a significant reduction of depressive symptoms after rTMS. However, plasma concentrations of neuroactive steroids were not affected by rTMS and not related to clinical response. Clinical improvement after extended daily treatment with rTMS is not accompanied by changes in neuroactive steroid levels. Changes in neuroactive steroid levels after antidepressant pharmacotherapy more likely reflect specific pharmacological effects of antidepressant drugs and are not necessary for the amelioration of depressive symptoms.

Original languageEnglish
Pages (from-to)874-878
Number of pages5
Issue number5
Publication statusPublished - Nov 1 2002


  • Affective disorders
  • Antidepressant treatment
  • Neuroactive steroids
  • Prefrontal cortex
  • TMS
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Pharmacology


Dive into the research topics of 'Plasma concentrations of neuroactive steroids before and after repetitive transcranial magnetic stimulation (rTMS) in major depression'. Together they form a unique fingerprint.

Cite this