Chrono-biological Hypothalamic–Pituitaryâ€� | 6036
Journal of Thyroid Disorders & Therapy

Journal of Thyroid Disorders & Therapy
Open Access

ISSN: 2167-7948

+44 1300 500008

Chrono-biological Hypothalamic–Pituitary–Thyroid axis status and anti-depressant outcome in major depression

International Conference on Thyroid Disorders and Treatment

February 29-March 01, 2016 Philadelphia, Pennsylvania, USA

Fabrice Duval, Marie-Claude Mokrani, Alexis Erb, Felix Gonzalez Lopera, Claudia Alexa and Xenia Proudnikova

Centre Hospitalier de Rouffach, France

Posters & Accepted Abstracts: Thyroid Disorders Ther

Abstract :

Background: The difference between 11 PM and 8 AM TSH response to TRH tests on the same day (�?�?�?�?TSH test) is an improved measure in detecting hypothalamic-pituitary-Thyroid (HPT) axis dysregulation in depression. This chrono-biological index (1) is reduced in about three quarters of major depressed inpatients and (2) is normalized after successful antidepressant treatment. Methods: In this present study, the �?�?�?�?TSH test was performed in 50 drug-free DSM-IV euThyroid major depressed inpatients and 50 hospitalized controls. After 2 weeks of antidepressant treatment, the �?�?�?�?TSH test was repeated in all inpatients. Antidepressant response was evaluated after 6 weeks of treatment. Results: At baseline, �?�?�?�?TSH values were significantly lower in patients compared to controls and 38 patients (76%) showed reduced �?�?�?�?TSH values (i.e., <2.5 mU/L). After two weeks of anti-depressant treatment, 20 patients showed �?�?�?�?TSH normalization (among them 18 were subsequent remitters), while 18 patients did not normalize their �?�?�?�?TSH (among them 15 were non-remitters) (p<0.00001). Among the 12 patients who had normal �?�?�?�?TSH values at baseline, 8 out 9 who had still normal values after 2 weeks of treatment were remitters, while the 3 with worsening HPT axis function (i.e., reduced �?�?�?�?TSH value after 2 weeks of treatment) were non-remitters (p<0.02). A logistic regression analysis revealed that �?�?�?�?TSH levels after 2 weeks of treatment could predict the probability of remission. Conclusions: Our results suggest that (1) chrono-biological restoration of the HPT axis activity precedes clinical remission and (2) altered HPT axis function after 2 weeks of anti-depressant is associated with treatment resistance.

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