Nocturnal TSH and prolactin secretion during sleep deprivation and prediction of antidepressant response in patients with major depression

Abstract

In order to test the hypothesis that changes in the hypothalamic-pituitary axis during sleep deprivation are related to the antidepressant effects of this procedure, we measured thyroid-stimulating hormone (TSH) and prolactin levels in 32 depressed patients at 2:00 am during a night before, during, and after total sleep deprivation (TSD). TSH levels increased significantly ( p < 0.05) during TSD, and prolactin levels decreased significantly ( p < 0.0001). When we divided the patients into responder and nonresponder groups based on a 30% reduction in the Hamilton Rating Scale, there was no difference between the two groups in their hormone levels on the baseline, TSD, or recovery nights. Changes in prolactin or TSH were not correlated with clinical improvement when the two groups were considered together or in the responder/ nonresponder groups separately. Baseline values of both hormones were significantly ( p < 0.01) correlated with their respective levels during TSD and recovery sleep. These findings indicate that the relative levels of nocturnal TSH and prolactin are stable even within acutely depressed individuals and that changes in their levels are not related to the clinical response to sleep deprivation.