Ulrich Voderholzer

Profiles of spontaneous 24-hour and stimulated growth hormone secretion in male patients with endogenous depression

Abnormalities of both the spontaneous and the stimulated release of growth hormone (GH) have been described in patients with endogenous depression. In this study, six unmedicated male patients with endogenous depression (ICD 296.1/3) were compared with six age-matched healthy men. Levels of GH were determined at 15-minute intervals over 26 hours. A combined releasing hormone test was performed during the last 2 hours of blood sampling. The 24-hour profile of GH secretion was significantly lower in the depressed patients than in the healthy control subjects due to a significantly diminished sleep-related GH secretion. GH stimulation following releasing hormones was lower in the depressed patients than in healthy subjects. Hypersecretion of GH before the stimulation test might therefore not explain the blunted GH response to stimulation that has been observed in depressive patients.

The neuroendocrine effects of venlafaxine in healthy subjects

Venlafaxine hydrochloride represents a novel chemical class of antidepressant compounds. In preclinical studies it had monoamine uptake inhibitory properties. It specifically inhibited the uptake of serotonin (5‐HT) norepinephrine (NE) and dopamine (DA) in rat brain synaptosomes. Previous studies showed that various classes of psychotropic drugs with different effects on central aminergic systems exhibit distinct neuroendocrine profiles. In this study we investigated the effect of ascending doses of venlafaxine (12.5 mg, 25 mg, 50 mg, 75 mg orally) on neuroendocrine function in six healthy male subjects, using a single‐blind, placebo‐controlled study design. After the ascending doses of venlafaxine there could be demonstrated descriptively an influence on GH, and prolactin after the higher doses of venlafaxine. The cortisol secretion was statistically significantly influenced by venlafaxine, and showed a dose‐dependent increased. These neuroendocrine effects of venlafaxine may be interpreted as being a result of 5‐HT and NE reuptake‐inhibition properties of the substance. Evidence for a DA reuptake‐inhibition was not found as DA‐agonists lead to an inhibition of prolactin secretion.

Lateralization of the bereitschaftspotential to the left hemisphere i patients with major depression

Fourteen patients with major depression and 18 healthy subjects performed a Bereitschaftspotential (BP) paradigm, which required them to clench the right fist at self-paced intervals. The BP was calculated as the integrated negative amplitude from BP onset to movement onset. The latter was defined by recording the electromyogram (EMG) from the right forearm. To evaluate lateralization, the integrated BPs at C3, C4, P3, and P4 were analyzed. In depressives, a significant asymmetry of the BP to the left was found, whereas in normals the BP was nearly symmetrically distributed around the midline. Three patients were retested when clinically improved. At that time the asymmetry to the left hemisphere had nearly vanished. This asymmetry to the left hemisphere is interpreted as a cortical deactivation of the right cerebral hemisphere and seems to be a state marker of depression.

Influence of clenbuterol, a β-adrenergic agonist, on desipramine induced growth hormone, prolactin and cortisol stimulation

We report herein the effects of the beta-adrenergic agonist clenbuterol on desipramine (DMI)-induced growth hormone (GH), prolactin (PRL) and cortisol secretion in healthy male subjects. In the first study, nine subjects were treated with either clenbuterol (0.04 mg, p.o.) or placebo. In the second study, 12 subjects received either DMI (50 mg, i.v.) alone or in combination with clenbuterol (0.04 mg, p.o.) given 60 min prior to DMI administration. Clenbuterol alone had no influence on GH, PRL, or cortisol concentrations, compared to placebo. DMI alone caused GH stimulation (mean maximum = 15.7 +/- 3.4 ng/ml), which was significantly lower after combined administration of DMI and clenbuterol (mean maximum = 7.7 +/- 1.6 ng/ml) (p less than or equal to 0.01). DMI-induced PRL and cortisol stimulation was not influenced by clenbuterol pretreatment. These results indicate the inhibiting influence of noradrenergic beta-receptors on GH stimulation.

Dependency of growth hormone (GH) stimulation following releasing hormones on the spontaneous 24-hour GH secretion in healthy male and female subjects.

The purpose of this investigation was to evaluate whether in healthy subjects the GH response following stimulation with releasing hormones is dependent on the spontaneous GH secretion within 24 hr prior to the stimulation test. In 18 male and 9 female healthy subjects (21-59 years) GH was measured every 15 min over 26 hr. Twenty-four hours after the beginning of blood sampling, a GH stimulation test was performed by using a combined releasing hormone test. Sleep was recorded in three consecutive nights. A positive correlation was found between the AUCs of the 24-hr GH secretion and the AUCs of GH stimulation, which could not be explained by an age effect only. This study demonstrates that subjects with comparatively high amounts of GH secreted within 24 hr also show good GH secretory responses when immediately after the 24-hr sampling period a stimulation test is undertaken. Therefore, a low GH response to stimulation cannot be explained by feedback effects of high GH amounts secreted during the 24 hr before the test or by empty pituitary GH storages.

Endocrine Response to Tricyclic Antidepressants and Peptides in Depression with Special Regard to Growth Hormone Secretion

Within the last 20 years neuroendocrinological investigations have become increasingly relevant in the context of depression research. The secretion of growth hormone (GH), ACTH/cortisol, and thyroid-stimulating hormone (TSH) have been studied extensively. The present paper primarily refers to the stimulation of GH secretion following the administration of tricyclic antidepressants and releasing hormones in depressive patients.

The Simultaneous Use of Four Releasing Factors: Theoretical and Practical Issues

In recent years, psychoneuroendocrinological interest has focused on the releasing and inhibiting hormones which regulate the secretion of anterior pituitary hormones (APH). In psychiatric research, thyroid-stimulating hormone (TSH) secretion, growth hormone (GH) secretion, the hypothalamus-pituitary-adrenal (HPA) axis, and the prolactin stimulation induced by neuroleptic drugs have been of special interest in the context of depressive disorder and addiction.

Gesunde Ernährung, gestörtes Essverhalten und Nahrungsmittelängste

Berichte über vermeintlich schädliche oder nützliche Auswirkungen bestimmter Ernährungsformen lösen oft Ängste aus, die insbesondere bei vulnerablen Personen zu dysfunktionalen Überzeugungen und Verhaltensweisen führen können. Neue, aber noch als vorläufig zu bewertende Befunde beschäftigen sich jedoch auch mit einer möglichen positiven Beeinflussung psychischer Erkrankungen durch Ernährung.

“Phobie à deux” and other reasons why clinicians do not apply exposure with response prevention in patients with obsessive–compulsive disorder

ABSTRACT Meta-analyses suggest that exposure with response prevention (ERP) is the most efficacious treatment for obsessive–compulsive disorder (OCD) and treatment guidelines for the disorder accordingly recommend ERP. Despite this, many therapists, including those with a cognitive-behavioral therapeutic background, do not perform ERP in patients with OCD. The present study aimed to elucidate the reasons why. German therapists (N = 216) completed an anonymous online survey, the newly developed Reasons for Not Performing Exposure in OCD Scale (REPEX), that inquired whether, to what extent, and how they perform ERP in the treatment of OCD. We also asked their reasons for not applying ERP in the past. Most therapists considered ERP an efficient treatment for OCD. Marked differences emerged between physicians and psychologists, however. The former used exposure less often and for a shorter period, preferred in sensu to in vivo exposure, and conducted exposure less often in the personal environment of the patient than did psychologists. Both groups were familiar with clinical guidelines to a similar extent. A factor analysis of the REPEX scale revealed five factors. Patient lack of motivation, preference for exposure to be self-help as well as alleged organizational difficulties were endorsed most often. The latter was correlated with the age of the therapist and was far more often affirmed by physicians. Fear of side effects was named by a subgroup of clinicians; in the context of patient ambivalence, this may foster “phobie à deux”. Unlike prior research, lack of expertise was rarely identified as a reason not to use ERP. Recommendations for improving adherence to guidelines are discussed.

Psychosoziale Risikofaktoren für psychische Störungen im Jugendalter

ZusammenfassungPsychosoziale Risikofaktoren können die psychische und physische Gesundheit von Kindern und Jugendlichen bis weit in das Erwachsenenalter hinein beeinflussen. Deshalb ist es wesentlich, mögliche Entwicklungsrisiken frühzeitig zu erkennen und in der weiteren Therapie zu berücksichtigen.