engleski

The influence of acute paroxetine treatment on peripheral biochemical markers in depressed patients

Objective: Peripheral biochemical markers, including platelet serotonin (5-Hydroxytryptamine, 5-HT), plasma cortisol and prolactin concentrations, are altered in major depression. Method: Platelet 5-HT, plasma cortisol and prolactin concentrations were determined after acute paroxetine treatment in nonpsychotic depressed female patients. The aim of the study was to investigate the acute effects of two different doses of paroxetine (20 and 40 mg, p.o., given after sampling at 8.00 h) on platelet 5-HT, plasma cortisol and prolactin concentrations, determined at 8.00, 9.00, 10.00 and 11.00 h, to study diurnal fluctuations and the relationship between pre- and post-treatment values, and to compare them to control group consisted of female drug free depressed patients. Results: Platelet 5-HT concentration did not show any diurnal rhythm and did not differ significantly in drug free depressed patients (F=0.067, p=0.977), in patients received lower (F=0.971, p=0.425) or higher (F=0.153, p=0.927) dose of paroxetine. Plasma cortisol levels were significantly (Kruskal-Wallis ANOVA by ranks) different in drug-free depressed patients (H=13.366, df=3, p=0.004), but were similar in depressed patients treated with paroxetine 20 mg (H=6.891, df=3, p=0.075), or 40 mg (H=5.432, df=3, p=0.143). All pairwise multiple comparisons (Student Newman Keuls test) revealed diurnal variations in plasma cortisol levels, i.e. highest values at 8.00 h and decline with consecutive sampling, with the lowest levels at 11.0 h. Repeated measures one-way ANOVA showed significant differences in plasma cortisol levels in drug free depression (F=10.57, p<0.01) and depressed patients treated with lower (F=4.715, <0.01) and higher (F=3.865, p<0.03) dose of paroxetine. Plasma prolactin levels did not differ significantly in drug-free depression (H=0.258, df=3, p=0.968), in depresed patients treated with lower (H=3.083, df=3, p=0.379), or higher (H=0.943, df=3, p=0.815) dose of paroxetine, and did not show any diurnal fluctuations. Conclusions: These data suggest that acute paroxetine treatment does not affect platelet 5-HT concentration, or plasma prolactin levels in depressed patients, but that both doses of paroxetine (especially 40 mg) suppressed in part diurnal variations in plasma cortisol levels in treated patients, which were observed in drug-free depressed patients.

major depression; paroxetine

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