The intervention effects of fluoxetine hydrochloride on hypothalamic-pituitary-thyroid axis function deficiency in patients with poststrok depression

Abstract

Objective To investigate the intervention effects of fluoxetine on hypothalamic-pituitary-thyroid (HPT) axis function changes in post-stroke depression (PSD) patients. Methods Mild to moderate stroke patients were enrolled and blood T3 , T4, FT3, FT4 and TSH were measured at day 0, 1, 7, 14, 21 and 3 months. At day 7, thyroid hormone releasing hormone (TRH) stimulation test were performed. After evaluated with the anxiety scale screening using the HAMD scale assessment at day 21, the subjects were divided into simple stroke subgroup (<8 points, 25 cases) and PSD sub-group (≥ 8 points, 18 cases), with 16 healthy age and sex matched individuals as control group. In the 2nd stage, TRH stimulation test were performed in PSD patients before and after 7 days of fluoxetine administration. Results Compared with control group, stroke patients presented lower FT3 (P 0.05). TRH test showed that the responses in PSD patients were lower than those in simple stroke patients((2.65±0.42)μIU/ml vs (5.31±0.68)μIU/ml, P<0.05). Correlation analysis showed HAMD scores correlated with TSH level changes and TSH0~30 in PSD subgroup closely(r=0.35, 0.25, P<0.01). In the 2nd stage, TRH test showed that PSD patients who took fluoxetine presented a lower TSH level change than PSD patients who did not((4.61±2.02)μIU/ml vs (7.05±2.12)μIU/ml, P<0.05). Conclusion PSD patients present a long and severe HPT axis function inhibition, which may due to TRH deficiency, and fluoxetine may improve this abnormality. Key words: Hypothalamic-pituitary-thyroid axis; Post-strok depression; Fluoxetine hydrochloride