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EPA-1654 – Impact on Cortisol and Antidepressant Efficacy of Quetiapine and Escitalopram in Depression

Published online by Cambridge University Press:  15 April 2020

N. Sarubin ,
C. Nothdurfter ,
C. Schmotz ,
A.M. Wimmer ,
J. Trummer ,
M. Lieb ,
M. Uhr ,
T.C. Baghai ,
T.C. Wetter  and
M. Bühner
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N. Sarubin
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
C. Nothdurfter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
C. Schmotz
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
A.M. Wimmer
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
J. Trummer
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
M. Lieb
Affiliation:
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
M. Uhr
Affiliation:
Max-Planck-Institute of Psychiatry, Max-Planck-Institute of Psychiatry, Munich, Germany
T.C. Baghai
Affiliation:
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
T.C. Wetter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
M. Bühner
Affiliation:
Department of Psychology/Statistics and Evaluation, Ludwig-Maximilian-University, Munich, Germany
R. Rupprecht
Affiliation:
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
C. Schüle
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany

Abstract

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Background

In this study, the impact of quetiapine fumarate extended release (QXR) and escitalopram (ESC) on HPA axis activity was investigated in depressed patients in relationship to antidepressant efficacy.

Methods

In a randomized, open-label 5-week trial 60 inpatients suffering from major depression (DSM-IV criteria) were treated for 5 weeks with either QXR (300 mg/day) or ESC (10 mg/day). The dexamethasone/CRH (DEX/CRH) test was performed before treatment, after 1, and after 5 weeks of treatment. Cortisol (COR) AUC values were used to assess HPA axis function. The Hamilton Depression Rating Scale was used weekly to estimate antidepressant efficacy.

Results

QXR and ESC showed comparable antidepressant effects but strongly differed in their impact on HPA axis activity. In the QXR group, a marked inhibition of COR AUC levels was observed which was most pronounced after one week of treatment but showed a partial re-increase after 5 weeks of treatment. In contrast, ESC transiently stimulated COR AUC values (week 1) whereas COR AUC levels at week 0 and week 5 were comparable. COR improvement at week 1 (defined as COR peak value reduction between DEX/CRH test 1 and 2) was significantly associated with better clinical outcome.

Conclusion

Apparently, different effects on HPA axis activity reflect distinct pharmacoendocrinological properties of psychotropic drugs.

Type
E02 - e-Poster Oral Session 02: Depression and Suicide
Information
European Psychiatry , Volume 29 , Issue S1: Abstracts of the 22nd European Congress of Psychiatry , 2014 , pp. 1 - 2
Copyright
Copyright © European Psychiatric Association 2014
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