Increased plasma norepinephrine concentration in psychotic depression

Goekoop, Jaap G.; de Winter, Remco F.P.; Wolterbeek, Ron; Van Kempen, Godfried M.J.; Wiegant, Victor M.

doi:10.1177/2045125312436574

Cited by 16Treatment of Major DepressionStress Responses and CortisolSchizophrenia research and treatment

Increased plasma norepinephrine concentration in psychotic depression

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Goekoop, Jaap G., de Winter, Remco F.P., Wolterbeek, Ron, Van Kempen, Godfried M.J., Wiegant, Victor M.·2012·Therapeutic Advances in Psychopharmacology

DOI 10.1177/2045125312436574PMC PMC3736933

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Abstract

OBJECTIVE: We previously found psychotic depression (PSDEP) to have positively correlating plasma norepinephrine (NE) and vasopressin (AVP) concentrations. Since central noradrenergic activity and plasma NE concentration are highly correlated, this suggests an increased noradrenergic activation of the hypothalamus-pituitary-adrenal axis. We hypothesize the increased release of NE in PSDEP to be an associated mechanism. METHODS: To test this hypothesis we analyzed the relation between plasma NE and PSDEP in a comparison with non-psychotically depressed patients. Potentially confounding variables were, among others, melancholia and two better validated subcategories in the field of melancholia and endogenous depression, three global dimensions of psychopathology - Emotional Dysregulation, Retardation and Anxiety - smoking habit, and different types of psychotropic and particularly antidepressant treatment. The data from nine patients with PSDEP and 69 patients with non-PSDEP were reanalysed. RESULTS: Analysis of covariance controlling for the effects of tricyclic antidepressant treatment (≥100 mg) and smoking habit showed that PSDEP had an increased concentration of plasma NE. The previously found correlation between plasma NE and AVP was still present after correcting for the effects of confounding variables. CONCLUSIONS: The results suggest an increased activity of the sympathetic nervous system in PSDEP that may act as a specific mechanism for increased vasopressinergic activation. This supports the view of PSDEP as a distinct subcategory of major depression.

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Experiential avoidance has been associated with anxiety.
“Experiential avoidance seeks to control the way or frequency of aversive private experiences [37] and has been associated with anxiety [38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54].”
From The Effect of Anxiety and Nutritional Habits on the Body Distortion of Athletes. (2025) · cites this paper as [44]
The Results discuss anxiety as a dimension related to plasma norepinephrine in patients with depression, not its association with experiential avoidance. A Discussion passage mentions conditioned avoidance behaviour in animal models, which is not the same construct. Searches for “experiential avoidance associated with anxiety” and “experiential avoidance control aversive private experiences” found no passage addressing the claimed association; page numbers were not available in our copy. (LLM, conf=0.76)
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Evidence of vasopressinergic-noradrenergic mechanisms in depression with above-normal plasma vasopressin concentration with and without psychotic features
Goekoop, J. G., de Winter, R. F. P., Wolterbeek, R., Kempen, G. M. J. V., & Wiegant, V. M. (2009) · Journal of Psychopharmacology · doi:10.1177/0269881109349839 · Cited by 9 · see citing works
Plasma Norepinephrine Level in Affective Disorders
Roy, A. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790350055010 · Cited by 183 · see citing works
Plasma Levels of Arginine Vasopressin Elevated in Patients with Major Depression
van Londen, L. (1997) · Neuropsychopharmacology · doi:10.1016/s0893-133x(97)00054-7 · Cited by 306 · see citing works
Sympathetic Nervous System Activity in Major Depression
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Plasma norepinephrine responses to cold challenge in depressed patients and normal controls
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Authors: Goekoop, J. G., de Winter, R. F. P., Wolterbeek, R., Van Kempen, G. M. J., & Wiegant, V. M.
Affiliations: Leiden University Medical Center (NL)
Venue: Therapeutic Advances in Psychopharmacology
Publisher: SAGE Publications
Published: 2012-02-09
Volume: 2
Issue: 2
Pages: 51-63
ISSN: 2045-1253 (ISSN-L)
2045-1261
DOI: 10.1177/2045125312436574
PMC: PMC3736933
OpenAlex: W2053805891
Cited by: 16
References: 61
Citations by year: 2026: 1 · 2025: 4 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2018: 3 · 2014: 1
FWCI: 0.24
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Therapeutic Advances in Psychopharmacology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords: psychotic depression, plasma norepinephrine, vasopressin, noradrenergic activation, hypothalamic-pituitary-adrenal axis, sympathetic nervous system, melancholia, endogenous depression, tricyclic antidepressants, smoking

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Increased plasma norepinephrine concentration in psychotic depression

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