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Carbamazepine Increases Cerebrospinal Fluid Thyrotropin-Releasing Hormone Levels in Affectively Ill Patients

Lauren B. Marangell, MD; Mark S. George, MD; Garth Bissette, PhD; Peggy Pazzaglia, MD; Teresa Huggins, PhD; Robert M. Post, MD
Arch Gen Psychiatry. 1994;51(8):625-628. doi:10.1001/archpsyc.1994.03950080037005.
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Background:  Thyrotropin-releasing hormone is an endogenous tripeptide with endocrine-independent neurophysiologic properties that may be relevant to affective or seizure disorders. We studied the effect of carbamazepine, which has both mood-stabilizing and anticonvulsant properties, on cerebrospinal fluid thyrotropin-releasing hormone levels in affectively ill patients.

Method:  Paired cerebrospinal fluid samples were collected from nine inpatients with mood disorders, both while medication free and while taking carbamazepine for an average of longer than 1 month at 950 mg/d, achieving blood levels of 8.8 mg/L.

Results:  Carbamazepine treatment was consistently and significantly associated with increased cerebrospinal fluid thyrotropin-releasing hormone levels (P<.0001).

Conclusion:  As carbamazepine-induced increases in thyrotropin-releasing hormone levels could be relevant to either its psychotropic or anticonvulsant properties, further clinical and preclinical investigation of this finding appears indicated.

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