Hypothalamic-pituitary-end organ function in women with bipolar depression

Natalie L. Rasgon, Heather A. Kenna, Ma Li Wong, Peter C. Whybrow, Michael Bauer

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Disturbance of each of the three hypothalamic-pituitary-end organ systems [hypothalamic-pituitary-thyroid (HPT), -adrenal (HPA), and -gonadal (HPG)] has been reported in depressive disorders. Little is known about potential reciprocal interaction among the three HP-end organ systems in patients with depressive disorders. The present pilot study examined selective HPA and HPG hormones in a detailed time series in women with bipolar disorder (depressed type) before and after treatment with levothyroxine (L-T4), and in matched control subjects. Six medically stable, euthyroid, premenopausal women with bipolar depression, and 5 age-matched controls underwent overnight blood sampling from 2100 to 0900 h for measurement of adrenocorticotropic hormone (ACTH), cortisol, luteinizing hormone (LH), and estradiol every 15 min. Bipolar patients underwent a second overnight blood sampling procedure following 7-weeks of open-label add-on treatment with L-T4. Results revealed lower baseline cortisol parameters in bipolar patients in comparison to control subjects, while ACTH, LH, and estradiol parameters were similar. Thyroid hormones (TSH, free and total T4) were not correlated with any of the HPA or HPG hormones. ACTH and cortisol levels were correlated in control subjects, but not in bipolar patients. After L-T4 treatment, thyroid hormones increased significantly and depression scores significantly declined. No significant changes in HPA or HPG hormones parameters were observed, although the small sample size may have limited results. Upon visual inspection, ACTH and cortisol appeared to decrease after L-T4 treatment, while estradiol appeared to increase. These pilot data suggest lower levels of cortisol in women with bipolar depression, unlike previously published studies that reported higher cortisol in patients with depression. The data also suggest reciprocal changes in the HPA and HPG axes upon pharmacological modulation of the HPT system, although whether this change was due to the L-T4 treatment or the improvement of depression is unknown. The results are preliminary, and require replication in larger samples.

LanguageEnglish
Pages279-286
Number of pages8
JournalPsychoneuroendocrinology
Volume32
Issue number3
DOIs
Publication statusPublished - 1 Apr 2007

Keywords

  • Bipolar disorder
  • Depression
  • HPA
  • HPG
  • HPT
  • Women

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Endocrine and Autonomic Systems
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Rasgon, N. L., Kenna, H. A., Wong, M. L., Whybrow, P. C., & Bauer, M. (2007). Hypothalamic-pituitary-end organ function in women with bipolar depression. Psychoneuroendocrinology, 32(3), 279-286. https://doi.org/10.1016/j.psyneuen.2006.12.014
Rasgon, Natalie L. ; Kenna, Heather A. ; Wong, Ma Li ; Whybrow, Peter C. ; Bauer, Michael. / Hypothalamic-pituitary-end organ function in women with bipolar depression. In: Psychoneuroendocrinology. 2007 ; Vol. 32, No. 3. pp. 279-286.
@article{da353f344407444ba76f07a601329656,
title = "Hypothalamic-pituitary-end organ function in women with bipolar depression",
abstract = "Disturbance of each of the three hypothalamic-pituitary-end organ systems [hypothalamic-pituitary-thyroid (HPT), -adrenal (HPA), and -gonadal (HPG)] has been reported in depressive disorders. Little is known about potential reciprocal interaction among the three HP-end organ systems in patients with depressive disorders. The present pilot study examined selective HPA and HPG hormones in a detailed time series in women with bipolar disorder (depressed type) before and after treatment with levothyroxine (L-T4), and in matched control subjects. Six medically stable, euthyroid, premenopausal women with bipolar depression, and 5 age-matched controls underwent overnight blood sampling from 2100 to 0900 h for measurement of adrenocorticotropic hormone (ACTH), cortisol, luteinizing hormone (LH), and estradiol every 15 min. Bipolar patients underwent a second overnight blood sampling procedure following 7-weeks of open-label add-on treatment with L-T4. Results revealed lower baseline cortisol parameters in bipolar patients in comparison to control subjects, while ACTH, LH, and estradiol parameters were similar. Thyroid hormones (TSH, free and total T4) were not correlated with any of the HPA or HPG hormones. ACTH and cortisol levels were correlated in control subjects, but not in bipolar patients. After L-T4 treatment, thyroid hormones increased significantly and depression scores significantly declined. No significant changes in HPA or HPG hormones parameters were observed, although the small sample size may have limited results. Upon visual inspection, ACTH and cortisol appeared to decrease after L-T4 treatment, while estradiol appeared to increase. These pilot data suggest lower levels of cortisol in women with bipolar depression, unlike previously published studies that reported higher cortisol in patients with depression. The data also suggest reciprocal changes in the HPA and HPG axes upon pharmacological modulation of the HPT system, although whether this change was due to the L-T4 treatment or the improvement of depression is unknown. The results are preliminary, and require replication in larger samples.",
keywords = "Bipolar disorder, Depression, HPA, HPG, HPT, Women",
author = "Rasgon, {Natalie L.} and Kenna, {Heather A.} and Wong, {Ma Li} and Whybrow, {Peter C.} and Michael Bauer",
year = "2007",
month = "4",
day = "1",
doi = "10.1016/j.psyneuen.2006.12.014",
language = "English",
volume = "32",
pages = "279--286",
journal = "Psychoneuroendocrinology",
issn = "0306-4530",
publisher = "Elsevier Limited",
number = "3",

}

Rasgon, NL, Kenna, HA, Wong, ML, Whybrow, PC & Bauer, M 2007, 'Hypothalamic-pituitary-end organ function in women with bipolar depression', Psychoneuroendocrinology, vol. 32, no. 3, pp. 279-286. https://doi.org/10.1016/j.psyneuen.2006.12.014

Hypothalamic-pituitary-end organ function in women with bipolar depression. / Rasgon, Natalie L.; Kenna, Heather A.; Wong, Ma Li; Whybrow, Peter C.; Bauer, Michael.

In: Psychoneuroendocrinology, Vol. 32, No. 3, 01.04.2007, p. 279-286.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hypothalamic-pituitary-end organ function in women with bipolar depression

AU - Rasgon, Natalie L.

AU - Kenna, Heather A.

AU - Wong, Ma Li

AU - Whybrow, Peter C.

AU - Bauer, Michael

PY - 2007/4/1

Y1 - 2007/4/1

N2 - Disturbance of each of the three hypothalamic-pituitary-end organ systems [hypothalamic-pituitary-thyroid (HPT), -adrenal (HPA), and -gonadal (HPG)] has been reported in depressive disorders. Little is known about potential reciprocal interaction among the three HP-end organ systems in patients with depressive disorders. The present pilot study examined selective HPA and HPG hormones in a detailed time series in women with bipolar disorder (depressed type) before and after treatment with levothyroxine (L-T4), and in matched control subjects. Six medically stable, euthyroid, premenopausal women with bipolar depression, and 5 age-matched controls underwent overnight blood sampling from 2100 to 0900 h for measurement of adrenocorticotropic hormone (ACTH), cortisol, luteinizing hormone (LH), and estradiol every 15 min. Bipolar patients underwent a second overnight blood sampling procedure following 7-weeks of open-label add-on treatment with L-T4. Results revealed lower baseline cortisol parameters in bipolar patients in comparison to control subjects, while ACTH, LH, and estradiol parameters were similar. Thyroid hormones (TSH, free and total T4) were not correlated with any of the HPA or HPG hormones. ACTH and cortisol levels were correlated in control subjects, but not in bipolar patients. After L-T4 treatment, thyroid hormones increased significantly and depression scores significantly declined. No significant changes in HPA or HPG hormones parameters were observed, although the small sample size may have limited results. Upon visual inspection, ACTH and cortisol appeared to decrease after L-T4 treatment, while estradiol appeared to increase. These pilot data suggest lower levels of cortisol in women with bipolar depression, unlike previously published studies that reported higher cortisol in patients with depression. The data also suggest reciprocal changes in the HPA and HPG axes upon pharmacological modulation of the HPT system, although whether this change was due to the L-T4 treatment or the improvement of depression is unknown. The results are preliminary, and require replication in larger samples.

AB - Disturbance of each of the three hypothalamic-pituitary-end organ systems [hypothalamic-pituitary-thyroid (HPT), -adrenal (HPA), and -gonadal (HPG)] has been reported in depressive disorders. Little is known about potential reciprocal interaction among the three HP-end organ systems in patients with depressive disorders. The present pilot study examined selective HPA and HPG hormones in a detailed time series in women with bipolar disorder (depressed type) before and after treatment with levothyroxine (L-T4), and in matched control subjects. Six medically stable, euthyroid, premenopausal women with bipolar depression, and 5 age-matched controls underwent overnight blood sampling from 2100 to 0900 h for measurement of adrenocorticotropic hormone (ACTH), cortisol, luteinizing hormone (LH), and estradiol every 15 min. Bipolar patients underwent a second overnight blood sampling procedure following 7-weeks of open-label add-on treatment with L-T4. Results revealed lower baseline cortisol parameters in bipolar patients in comparison to control subjects, while ACTH, LH, and estradiol parameters were similar. Thyroid hormones (TSH, free and total T4) were not correlated with any of the HPA or HPG hormones. ACTH and cortisol levels were correlated in control subjects, but not in bipolar patients. After L-T4 treatment, thyroid hormones increased significantly and depression scores significantly declined. No significant changes in HPA or HPG hormones parameters were observed, although the small sample size may have limited results. Upon visual inspection, ACTH and cortisol appeared to decrease after L-T4 treatment, while estradiol appeared to increase. These pilot data suggest lower levels of cortisol in women with bipolar depression, unlike previously published studies that reported higher cortisol in patients with depression. The data also suggest reciprocal changes in the HPA and HPG axes upon pharmacological modulation of the HPT system, although whether this change was due to the L-T4 treatment or the improvement of depression is unknown. The results are preliminary, and require replication in larger samples.

KW - Bipolar disorder

KW - Depression

KW - HPA

KW - HPG

KW - HPT

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=33947175250&partnerID=8YFLogxK

U2 - 10.1016/j.psyneuen.2006.12.014

DO - 10.1016/j.psyneuen.2006.12.014

M3 - Article

VL - 32

SP - 279

EP - 286

JO - Psychoneuroendocrinology

T2 - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

IS - 3

ER -