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Vol. 285, Issue 2, 579-587, May 1998
UNC Neuroscience Center, Center for Alcohol Studies, Departments of
Psychiatry, Anesthesiology and Pharmacology, University of North
Carolina at Chapel Hill, Chapel Hill, North Carolina
Hypersecretion of cortisol occurs in numerous patients with major
depression and normalizes with clinical recovery during the course of
chronic antidepressant treatment. These clinical data suggest that
investigation of the effects of antidepressant treatments on the
regulation of the brain-pituitary-adrenal axis may assist in
elucidating the therapeutic basis of antidepressant actions. In the
present investigation, both swim stress and acute fluoxetine challenge
increased release of corticosterone and progesterone to reflect an
activation of the brain pituitary-adrenal axis. The effects of chronic
antidepressant treatment (21 days) on corticosterone and progesterone
secretion induced by these challenges were investigated. Chronic
fluoxetine treatment (5 mg/kg/day) completely blocked the increased
secretion of corticosterone and progesterone in response to the acute
fluoxetine challenge. Chronic treatment with desipramine, imipramine or
amytriptyline (15 mg/kg/day) also markedly attenuated
fluoxetine-induced corticosterone and progesterone secretion. However,
chronic treatment with the monoamine oxidase inhibitors, phenelzine (5 mg/kg) and tranylcypromine (5 mg/kg), did not affect this hormonal
response to acute fluoxetine challenge. Plasma levels of fluoxetine
after acute challenge were not significantly different for the various
chronic antidepressant treatment conditions from the chronic saline
controls; therefore, an increase in the metabolism of fluoxetine can
not explain the antagonism of the fluoxetine-induced hormonal response
after chronic antidepressant treatment. In contrast to the effects of
selected antidepressants on acute fluoxetine-induced steroid release,
chronic treatment with imipramine (20 mg/kg/day), fluoxetine (5 mg/kg/day) or phenelzine (5 mg/kg) did not significantly alter this
swim stress-induced corticosterone or progesterone secretion. Because
chronic fluoxetine and tricyclic antidepressant drugs blocked the acute
action of fluoxetine to increase adrenal cortical secretion, but did
not alter swim stress-induced secretion of these steroids, we propose that distinct neurochemical mechanisms control fluoxetine and swim
stress-induced steroid release. We speculate that the substantial adaptive response to those chronic antidepressant treatments, which
minimize the effect of acute fluoxetine challenge to increase in
corticosterone and progesterone secretion, may be relevant to the
therapeutic actions of these drugs.
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