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Higher serum DHEA concentrations before and after SSRI treatment are associated with remission of major depression

By Christina M. Hough, Daniel Lindqvist, Elissa S. Epel, Molly St. Denis, Victor I. Reus, Francesco Saverio Bersani, Rebecca Rosser, Laura Mahan, Heather M. Burke, Owen M. Wolkowitz and Synthia H. Mellon

Abstract

Background: Dehydroepiandrosterone (DHEA) and its sulfated ester DHEA-sulfate (DHEA-S), (togetherDHEA[S]), are the most abundant adrenal steroids in humans and are found in blood and the brain, wherethey function as neurosteroids with direct receptor affinities. Preclinical studies suggest that DHEA(S)has antidepressant/neuroprotective properties, and exogenously administered DHEA has shown antide-pressant efficacy in humans. Nonetheless, the role of endogenous DHEA(S) levels in major depressivedisorder (MDD) and antidepressant outcomes remains unclear.Methods: Morning fasting serum DHEA(S) concentrations were determined in 36 healthy, unmedicatedMDD adults with Hamilton Depression (HDRS) ratings ≥17, and 75 healthy controls. MDD participantsthen completed eight weeks of open-label SSRI treatment before DHEA(S) levels were re-sampled; thosewith post-treatment HDRS ratings ≤7 were classified as “Remitters.” Pre- and post-treatment DHEA(S)levels of Remitters and Non-remitters were compared, controlling for age, sex, and BMI.Results: Pre-treatment HDRS ratings did not differ between Remitters and Non-remitters (p = 0.179). Base-line DHEA levels of Remitters were significantly higher than both Non-remitters (p = 0.008) and controls(p = 0.004); baseline DHEA-S levels of Remitters were also higher than Non-remitters (p = 0.040) but didnot significantly differ from controls (p = 0.096). Non-remitters did not significantly differ from con-trols. Post-treatment DHEA(S) levels remained higher in Remitters compared to Non-remitters (DHEA:p = 0.013; DHEA-S: p = 0.040).Conclusions: These data suggest that higher circulating DHEA(S) levels (while unmedicated and aftereight weeks of SSRI treatment) predict SSRI-associated remission in MDD. This raises the possibilitythat endogenous DHEA(S) abundance is a physiological adjunct to SSRI efficacy, as suggested by priorpreclinical and clinical studies

Topics: antidepressant response, dehydroepiandrosterone, depression, remission
Publisher: Elsevier Ltd
Year: 2017
DOI identifier: 10.1016/j.psyneuen.2016.11.035
OAI identifier: oai:iris.uniroma1.it:11573/1073192
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