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Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine
Abstract
The noradrenergic and specific serotoninergic antidepressant mirtazapine improves sleep, modulates hormone secretion including blunting of hypothalamic-pituitary-adrenocortical (HPA) activity, and may prompt increased appetite and weight gain. The simultaneous investigation of sleep electroencephalogram (EEG) and hormone secretion during antidepressive treatment helps to further elucidate these effects. We examined sleep EEG (for later conventional and quantitative analyses) and the nocturnal concentrations of cortisol, adrenocorticotropin (ACTH), growth hormone (GH), prolactin, melatonin and the key factors of energy balance, ghrelin, and leptin before and after 28 days of treatment of depressed patients (seven women, three men, mean age 39.9+/-4.2 years) with mirtazapine. In addition, a sleep EEG was recorded at day 2 and the dexamethasone-corticotropin-releasing hormone (DEX-CRH) test was performed to assess HPA activity at days -3 and 26. Psychometry and mirtazapine plasma concentrations were measured weekly. Already at day 2, sleep continuity was improved. This effect persisted at day 28, when slow-wave sleep, low-delta, theta and alpha activity, leptin and (0300-0700) melatonin increased, and cortisol and ghrelin decreased. ACTH and prolactin remained unchanged. The first two specimens of GH collected after the start of quantitative EEG analysis were reduced at day 28. The DEX-CRH test showed, at day 26, a blunting of the overshoot of ACTH and cortisol found at day -3.…
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“Some patients show improvement of sleep quality already after the first drug dose [15]”
From Effects of Antidepressants on Sleep (2017) · cites this paper as [15]
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Metadata
- Authors
- Schmid, D. A., Wichniak, A., Uhr, M., Ising, M., Brunner, H., Held, K., Weikel, J. C., Sonntag, A., & Steiger, A.
- Affiliations
- Max Planck Institute of Psychiatry (DE)
- Max Planck Society (DE)
- Corresponding author
- Steiger, Axel
- Venue
- Neuropsychopharmacology
- Published
- 2005-10-19
- Volume
- 31
- Issue
- 4
- Pages
- 832-844
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- OpenAlex
- W1985871443
- Cited by
- 165
- References
- 90
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 4 · 2023: 12 · 2022: 8 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 2 · 2015: 9 · 2014: 13 · 2013: 9 · 2012: 14
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- mirtazapine, depression, sleep architecture, sleep EEG, hypothalamic-pituitary-adrenal axis, cortisol, ACTH, growth hormone, prolactin, melatonin, ghrelin, leptin, 5-HT2 receptor, antidepressant side effects
- MeSH terms
- Mirtazapine, Adrenocorticotropic Hormone, Adult, Animals, Antidepressive Agents, Tricyclic, Body Weight, Circadian Rhythm, Depression, Dexamethasone, Dose-Response Relationship, Drug, Electroencephalography, Endocrine System, Female, Hormones, Humans, Hydrocortisone, Male, Melatonin, Mianserin, Middle Aged, Prolactin, Psychometrics, Sleep, Growth Hormone, Time Factors, Immunoradiometric Assay, Area Under Curve, Leptin, Peptide Hormones, Ghrelin
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