Antidepressant treatment with mirtazapine, but not venlafaxine, lowers cortisol concentrations in saliva: a randomised open trial

Lowering the concentrations of free cortisol in depressed patients may be an important prerequisite to prevent glucocorticoid-related sequelae of depression. We tested the hypothesis that the hypothalamus-pituitary-adrenal (HPA) system-dampening effects of venlafaxine and mirtazapine differ. We comp...

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Main Authors: Scharnholz, Barbara (Author) , Weber-Hamann, Bettina (Author) , Lederbogen, Florian (Author) , Schilling, Claudia (Author) , Gilles, Maria (Author) , Onken, Vera (Author) , Frankhauser, Pascal (Author) , Kopf, Daniel (Author) , Deuschle, Michael (Author)
Format: Article (Journal)
Language:English
Published: 8 April 2010
In: Psychiatry research
Year: 2010, Volume: 177, Issue: 1/2, Pages: 109-113
ISSN:1872-7123
DOI:10.1016/j.psychres.2009.08.010
Online Access:Resolving-System, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.psychres.2009.08.010
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0165178109003163
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Author Notes:Barbara Scharnholz, Bettina Weber-Hamann, Florian Lederbogen, Claudia Schilling, Maria Gilles, Vera Onken, Pascal Frankhauser, Daniel Kopf, Michael Deuschle
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Summary:Lowering the concentrations of free cortisol in depressed patients may be an important prerequisite to prevent glucocorticoid-related sequelae of depression. We tested the hypothesis that the hypothalamus-pituitary-adrenal (HPA) system-dampening effects of venlafaxine and mirtazapine differ. We compared the course of morning (08.00h) and afternoon saliva cortisol (16.00h) in 42 mirtazapine- and 45 venlafaxine-treated depressed patients during a 1-week wash-out and a 4-week treatment period in a randomised open trial. Mirtazapine lowered afternoon cortisol from week 1 to 4. In contrast, during the course of the entire treatment period, venlafaxine did not attenuate saliva cortisol concentrations. Treatment effects of mirtazapine on cortisol concentrations did not differ in remitters and non-remitters to treatment. High baseline cortisol concentrations, on the other hand, were related to an unfavourable course during venlafaxine treatment and patients remitting during venlafaxine treatment had significantly lower afternoon cortisol concentrations in saliva, when compared to non-remitting patients. Thus, mirtazapine and venlafaxine show different effects on HPA system activity as measured by saliva cortisol. This may be of relevance with regard to physical sequelae of depression.
Item Description:Gesehen am 31.05.2023
Physical Description:Online Resource
ISSN:1872-7123
DOI:10.1016/j.psychres.2009.08.010