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Effects of intrathecal thyrotropin-releasing hormone (protirelin) in refractory depressed patients.

Author(s): Marangell LB, George MS, Callahan AM, Ketter TA, Pazzaglia PJ, L'Herrou TA, Leverich GS, Post RM

Affiliation(s): Biological Psychiatry Branch, National Institutes of Mental Health, Bethesda, Md, USA.

Publication date & source: 1997-03, Arch Gen Psychiatry., 54(3):214-22.

Publication type: Clinical Trial; Controlled Clinical Trial; Randomized Controlled Trial

BACKGROUND: Therapeutic effects of the tripeptide protirelin (thyrotropin-releasing hormone) have been postulated in the affective disorders, but direct assessment in humans has been hindered by poor blood-brain barrier permeability. METHODS: Eight medication-free inpatients with refractory depression received 500 micrograms of protirelin via a lumbar intrathecal injection and an identical sham lumbar puncture procedure, separated by 1 week, in a double-blind crossover design. RESULTS: Five of eight patients responded to intrathecal protirelin, defined as a 50% or greater reduction in an abbreviated Hamilton Rating Scale for Depression score. Suicidality also was reduced significantly (P < .05). Responses were rapid and clinically robust, but short-lived. CONCLUSION: Administration of protirelin by an intrathecal route induced a rapid improvement in mood and suicidality in these refractory depressed patients, supporting the hypothesis that thyrotropin-releasing hormone could be a positive modulator of mood.

Page last updated: 2006-01-31

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