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Vasopressin surrogate marker copeptin as a potential novel endocrine biomarker for antidepressant treatment response in major depression: A pilot study

Published online by Cambridge University Press:  13 August 2021

A. Agorastos ,
A. Sommer ,
K. Wiedemann  and
C. Demiralay
A. Agorastos*
Affiliation:
Ii. Dept. Of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece
A. Sommer
Affiliation:
Psychiatry & Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
K. Wiedemann
Affiliation:
Psychiatry & Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
C. Demiralay
Affiliation:
Psychiatry & Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
*
*Corresponding author.

Abstract

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Introduction

Major depressive disorder (MDD) constitutes the leading cause of disability worldwide. Although efficacious antidepressant pharmacotherapies exist for MDD, only about 40-60% of the patients respond to initial treatment. However, there is still a lack of robustly established and applicable biomarkers for antidepressant response in everyday clinical practice.

Objectives

This study targets the assessment of the vasopressin (AVP) surrogate marker Copeptin (CoP), as a potential peripheral hypothalamic-level biomarker of antidepressant treatment response in MDD.

Methods

We measured baseline and dynamic levels of plasma CoP along with plasma ACTH and cortisol (CORT) in drug-naive outpatients with MDD before and after overnight manipulation of the hypothalamic-pituitary-adrenal (HPA) axis [i.e., stimulation (metyrapone) and suppression (dexamethasone)] on three consecutive days and their association with treatment response to 4 weeks of escitalopram treatment.

Results

Our findings suggest significantly higher baseline and post-metyrapone plasma CoP levels in future non-responders, a statistically significant invert association between baseline CoP levels and probability of treatment response and a potential baseline plasma CoP cut-off level of above 2.9 pmol/L for future non-response screening. Baseline and dynamic plasma ACTH and CORT levels showed no association with treatment response.

Conclusions

This pilot study provide first evidence in humans that CoP may represent a novel, clinically easily applicable, endocrine biomarker of antidepressant response, based on a single-measurement, cut-off level. These findings, underline the role of the vasopressinergic system in the pathophysiology of MDD and may represent a significant new tool in the clinical and biological phenotyping of MDD enhancing individual-tailored therapies.

Keywords

biomarkerhypothalamus-pituitary-adrenal (HPA) axisantidepressant responseDepression
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S454
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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