Zusammenfassung
Eine Überaktivität des Hypothalamus-Hypophysen-Nebennierenrinden-(HHN-)Systems spielt in der Pathophysiologie der Depression eine Schlüsselrolle. Dies lässt sich besonders gut an Veränderungen des Schlaf-EEGs und der schlafassoziierten Hormonsekretion von Patienten mit Depression zeigen. Gestörter Schlaf, Hyperkortisolismus und verminderte Wachstumshormonausschüttung sind charakteristische neurobiologische Symptome der Depression. Veränderungen im Gleichgewicht der Neuropeptide Corticotropin-freisetzendes Hormon (CRH) und Wachstumshormon-freisetzendes Hormon (GHRH) tragen wesentlich zu diesen Symptomen bei. Während der Hyperkortisolismus und pathologische Ergebnisse neurobiologischer Funktionstests des HHN-Systems als zustandsabhängige Variable bei stabiler Remission sich normalisieren, persistieren Veränderungen von Schlaf-EEG und Wachstumshormon als biologische Narbe langfristig nach Abklingen der psychopathologischen Symptome. Eine Reihe von Daten weist darauf hin, dass eine Normalisierung des HHN-Systems eng mit dem Wirkmechanismus von Antidepressiva verbunden ist. Ein Kronzeuge für diese Hypothese stellt Trimipramin dar. Die logische Konsequenz der Erkenntnisse der neuroendokrinen Grundlagen der Depression ist die Entwicklung von CRH-Antagonisten als neuartiges antidepressives Wirkprinzip.
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Literatur
Antonijevic IA, Murck H, Frieboes RM, Barthelmes J, Steiger A (2000 a) Sexually dimorphic effects of GHRH on sleep-endocrine activity in patients with depression and normal controls - part I: the sleep EEG. Sleep Research Online 3:5–13.
Antonijevic IA, Murck H, Frieboes RM, Steiger A (2000 b) Sexually dimorphic effects of GHRH on sleep-endocrine activity in patients with depression and normal controls - part II: hormone secretion. Sleep Research Online 3:15–21.
Ehlers CL, Reed TK, Henriksen SJ (1986) Effects of corticotropin-releasing factor and growth hormone-releasing factor on sleep and activity in rats. Neuroendocrinology 42:467–474.
Frieboes RM, Sonntag A, Yassouridis A, Eap CB, Baumann P, Steiger A. Clinical outcome after trimipramine in patients with delusional depression - a pilot study. Pharmacopsychiatry (submitted).
Guldner J, Schier T, Friess E, Colla M, Holsboer F, Steiger A (1997) Reduced efficacy of growth hormone-releasing hormone in modulating sleep endocrine activity in the elderly. Neurobiol Aging 18:491–495.
Holsboer F (1999) The rationale for corticotropin-releasing hormone receptor (CRH-R) an-tagonists to treat depression and anxiety. J Psychiatr Res 33:181–214.
Holsboer F (2000) The corticosteroid receptor hypothesis of depression. Neuropsychophar- macology 23:477–501.
Holsboer F, Steiger A, Maier W (1983) Four cases of reversion to abnormal dexamethasone suppression test response as indicator of clinical relapse: a preliminary report. Biol Psychiatry 18:911–916.
Holsboer F, von Bardeleben U, Steiger A (1988) Effects of intravenous corticotropin-releasing hormone upon sleep-related growth hormone surge and sleep EEG in man. Neuroendocrinology 48:32–38.
Iovino M, Monteleone P, Steardo L (1989) Repetitive growth hormone-releasing hormone administration restores the attenuated growth hormone (GH) response to GH- releasing hormone testing in normal aging. J Clin Endocrinol Metab 69:910–913.
Jarrett DB, Miewald JM, Kupfer DJ (1990) Recurrent depression is associated with a persistent reduction in sleep-related growth hormone secretion. Arch Gen Psychiatry 47:113–118.
Krueger JM, Obál Jr. F (1993) Growth hormone-releasing hormone and interleukin-1 in sleep regulation. FASEB J 7:645–652.
Kupfer DJ, Ehlers CL, Frank E, Grochocinski VJ, McEachran AB, Buhari A (1993) Electroencephalographic sleep studies in depressed patients during long-term recovery. Psychiatry Res 49:121–138.
Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. US Department of Health, Education & Welfare, Neurological Information Network Bethesda, MD.
Reul JM, Stec I, Söder M, Holsboer F (1993) Chronic treatment of rats with the antidepressant amitriptyline attenuates the activity of the hypothalamic-pituitary-adrenocortical system. Endocrinology 133:312–320.
Schatzberg AF, Rothschild AJ, Langlais PJ, Bird ED, Cole JO (1985) A corticosteroid/dopamine hypothesis for psychotic depression and related states. J Psychiatr Res 19:57–64.
Sonntag A, Rothe B, Guldner J, Yassouridis A, Holsboer F, Steiger A (1996) Trimipramine and imipramine exert different effects on the sleep EEG and on nocturnal hormone secretion during treatment of major depression. Depression 4:1–13.
Steiger A (1995) Schlafendokrinologie. Nervenarzt 66:15–27.
Steiger A (2001a) Sleep and the hypothalamo-pituitary-adrenocortical system. Sleep Medicine Reviews (in press).
Steiger A (2001b) Atypische Antidepressiva - Trimipramin. In: Riederer P, Pöldinger W, Laux G (Hrsg) Antidepressiva und Phasenprophylaktika/Stimmungsstabilisierer. Springer, Wien, im Druck.
Steiger A, von Bardeleben U, Herth T, Holsboer F (1989 a) Sleep EEG and nocturnal secretion of cortisol and growth hormone in male patients with endogenous depression before treatment and after recovery. J Affect Disord 16:189–195.
Steiger A, Benkert O, Wöhrmann S, Steinseifer D, Holsboer F (1989 b) Effects of trimipramine on sleep EEG, penile tumescence and nocturnal hormonal secretion. A long-term study in 3 normal controls. Neuropsychobiology 21:71–75.
Steiger A, Guldner J, Hemmeter U, Rothe B, Wiedemann K, Holsboer F (1992) Effects of growth hormone-releasing hormone and somatostatin on sleep EEG and nocturnal hormone secretion in male controls. Neuroendocrinology 56:566–573.
Steiger A, von Bardeleben U, Guldner J, Lauer C, Rothe B, Holsboer F (1993) The sleep EEG and nocturnal hormonal secretion. Studies on changes during the course of depression and on effects of CNS-active drugs. Prog Neuropsychopharmacol Biol Psychiatry 17: 125–137.
Steiger A, Holsboer F (1997) Neuropeptides and human sleep. Sleep 20:1038–1052.
Steiger A, Antonijevic IA (2001) Sleep-EEG changes after methylprednisolone therapy in multiple sclerosis are similar to those in depression. Exp Clin Endocrinol Diabetes 109 (Suppl 1):S64.
Wiedemann K, Lauer C, Loycke A et al. (1992) Antiglucocorticoid treatment disrupts endocrine cycle and nocturnal sleep pattern. Eur Arch Psychiatry Clin Neurosci 241:372–375.
Zobel AW, Yassouridis A, Frieboes RM, Holsboer F (1999) Prediction of medium-term outcome by Cortisol response to the combined dexamethasone-CRH test in patients with remitted depression. Am J Psychiatry 156:949–951.
Zobel AW, Künzel H, Sonntag A, Holsboer F (2000) Effects of the high-affinity corticotropin-releasing hormone receptor 1 antagonist R121919 in major depression: the first 20 patients treated. J Psychiatr Res 34:171–181.
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Steiger, A. (2002). Neuroendokrinologie der Depression. In: Laux, G. (eds) Depression 2000. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59394-9_3
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