TY - JOUR
T1 - Plasma concentrations of neuroactive steroids before and after repetitive transcranial magnetic stimulation (rTMS) in major depression
AU - Padberg, Frank
AU - Di Michele, Flavia
AU - Zwanzger, Peter
AU - Romeo, Elena
AU - Bernardi, Giorgio
AU - Schüle, Cornelius
AU - Baghai, Thomas C.
AU - Ella, Robin
AU - Pasini, Augusto
AU - Rupprecht, Rainer
PY - 2002/11/1
Y1 - 2002/11/1
N2 - 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.
AB - 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.
KW - Affective disorders
KW - Antidepressant treatment
KW - Neuroactive steroids
KW - Prefrontal cortex
KW - TMS
KW - Transcranial magnetic stimulation
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U2 - 10.1016/S0893-133X(02)00355-X
DO - 10.1016/S0893-133X(02)00355-X
M3 - Article
C2 - 12431862
AN - SCOPUS:0036846298
VL - 27
SP - 874
EP - 878
JO - Neuropsychopharmacology
JF - Neuropsychopharmacology
SN - 0893-133X
IS - 5
ER -