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Thyrotrophin-Releasing Hormone (TRH) Stimulation Test in Manic-Depressive Illness

Carsten Kirkegaard, MD; Niels Bjørum, MD; Dorte Cohn, MD; Ulrik Birk Lauridsen, MD
[+] Author Affiliations

Accepted for publication Aug 31, 1977.

Reprint requests to Department of Medicine E, Frederiksberg Hospital, DK-2000, Copenhagen F, Denmark (Dr Kirkegaard).


Arch Gen Psychiatry. 1978;35(8):1017-1021. doi:10.1001/archpsyc.1978.01770320111011
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• The thyrotrophin (TSH) response to thyrotrophin-releasing hormone (TRH) 200 μg intravenously was studied in 19 patients with unipolar depression, 12 with bipolar depression, 14 with mania, and 5 with mixed manic-depressive illness. The TSH responses were decreased in all of these affective disorders compared to those found in 10 patients with reactive depression, 5 with reactive paranoid psychosis, 14 with neurotic depression, and 60 controls. The decrease of the TSH response in manics could not be accounted for by the effects of neuroleptic drugs. The TSH response in the groups with reactive depression, reactive paranoid psychosis, and neurotic depression, respectively, did not differ significantly from that found in controls. With the exception of a decrease in serum T level and free T index in the manics, no significant differences in serum T3 level or in free T3 and T, indexes were found between the groups. Changes found in serum T, level were due to changes in the thyroxinebinding proteins.

REFERENCES

Prange AJ, Wilson IC, Lara PP, et al:  Effects of thyrotropin-releasing hormone in depression . Lancet 2:999-1002, 1972;.
Kastin AJ, Ehrensing RH, Schalch DS, et al:  Improvement in mental depression with decreased thyrotropin response after administration of thyrotropin-releasing hormone . Lancet 2:740-742, 1972;.
Takahashi S, Kondo H, Yoshimura M, et al:  Antidepressant effect of thyrotropin-releasing hormone (TRH) and the plasma thyrotropin levels in depression . Folia Psychiatr Neurol Jap 27:305-314, 1973;.
Coppen A, Montgomery S, Peet M, et al:  Thyrotropin-releasing hormone in the treatment of depression . Lancet 2:433-435, 1974;.
Ehrensing RH, Kastin AJ, Schalch DS, et al:  Affective state and thyrotropin and prolactin responses after repeated injections of thyrotropin-releasing hormone in depressed patients . Am J Psychiatry 131:714-718, 1974;.
Kirkegaard C, Nørlem N, Lauridsen UB, et al:  Protirelin stimulation test and thyroid function during treatment of depression . Arch Gen Psychiatry 32:1115-1118, 1975;.
Maeda K, Kato Y, Ohgo S, et al:  Growth hormone and prolactin release after injection of thyrotropin-releasing hormone in patients with depression . J Clin Endocrinol Metab 40:501-505, 1975;.
Kirkegaard C, Bjørum N, Cohn D, et al:  Studies of the influence of biogenic amines and psychoactive drugs on the prognostic value of the TRH stimulation test in endogenous depression . Psychoneuroendocrinology 2:131-136, 1977;.
Murphy BP:  The determination of thyroxine by competitive proteinbinding analysis employing an anion-exchange resin and radiothyroxine . J Lab Clin Med 66:161-167, 1965;.
Kirkegaard C, Friis T, Siersbaek-Nielsen K:  Measurements of serum triiodothyronine by radioimmunoassay . Acta Endocrinol 77:71-81, 1974;.
Lauridsen UB, Deckert T, Friis T, et al:  Estimation of serum thyrotropin (TSH) and stimulation with thyrotropin-releasing hormone (TRH) in thyroid diseases . Acta Med Scand 196:171-176, 1974;.
Takahashi S, Kondo H, Yoshimura M, et al:  Thyrotropin responses to TRH in depressive illness: Relation to clinical subtypes and prolonged duration of depressive episode . Folia Psychiatr Neurol Jap 28:355-365, 1974;.
Takahashi S, Kondo H, Yoshimura M, et al:  Thyroid function levels and thyrotropin responses to TRH administration in manic patients receiving lithium carbonate . Folia Psychiatr Neurol Jap 29:231-237, 1975;.
Burg W van den, Praag HM van, Bos ERH, et al:  Thyrotropin releasing hormone (TRH) as a possible quick-acting but short-lasting anti-depressant . Psychol Med 5:404-412, 1975;.
Chopra IJ, Chopra U, Smith SR, et al:  Reciprocal changes in serum concentrations of 3,3', 5'-triiodothyronine (reverse T,) and 3,3'5-triiodothyronine (T,) in systemic illnesses . J Clin Endocrinol Metab 41:1043-1049, 1975;.
Besses GS, Burrow GN, Spaulding SW, et al:  Dopamine infusion acutely inhibits the TSH and prolactin response to TRH . J Clin Endocrinol Metab 41:985-988, 1975;.
Horn AS, Snyder SH:  Chlorpromazine and dopamine: Conformational similarities that correlate with the antischizophrenic activity of phenothiazine drugs . Proc Natl Acad Sci USA 68:2325-2328, 1971;.
Jarvik ME:  Drugs used in the treatment of psychiatric disorders , in Goodman LS, Gilman A (eds): The Pharmacological Basis of Therapeutics , ed 4. New York, Macmillan Co, 1970;, pp 169-170.
Paracchi A, Ferrari C, Faglia G:  Catecholaminergic and serotonergic influences on thyrotropin secretion in man . Acta Endocrinol 199( (suppl) ):316, 1975;.

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Prange AJ, Wilson IC, Lara PP, et al:  Effects of thyrotropin-releasing hormone in depression . Lancet 2:999-1002, 1972;.
Kastin AJ, Ehrensing RH, Schalch DS, et al:  Improvement in mental depression with decreased thyrotropin response after administration of thyrotropin-releasing hormone . Lancet 2:740-742, 1972;.
Takahashi S, Kondo H, Yoshimura M, et al:  Antidepressant effect of thyrotropin-releasing hormone (TRH) and the plasma thyrotropin levels in depression . Folia Psychiatr Neurol Jap 27:305-314, 1973;.
Coppen A, Montgomery S, Peet M, et al:  Thyrotropin-releasing hormone in the treatment of depression . Lancet 2:433-435, 1974;.
Ehrensing RH, Kastin AJ, Schalch DS, et al:  Affective state and thyrotropin and prolactin responses after repeated injections of thyrotropin-releasing hormone in depressed patients . Am J Psychiatry 131:714-718, 1974;.
Kirkegaard C, Nørlem N, Lauridsen UB, et al:  Protirelin stimulation test and thyroid function during treatment of depression . Arch Gen Psychiatry 32:1115-1118, 1975;.
Maeda K, Kato Y, Ohgo S, et al:  Growth hormone and prolactin release after injection of thyrotropin-releasing hormone in patients with depression . J Clin Endocrinol Metab 40:501-505, 1975;.
Kirkegaard C, Bjørum N, Cohn D, et al:  Studies of the influence of biogenic amines and psychoactive drugs on the prognostic value of the TRH stimulation test in endogenous depression . Psychoneuroendocrinology 2:131-136, 1977;.
Murphy BP:  The determination of thyroxine by competitive proteinbinding analysis employing an anion-exchange resin and radiothyroxine . J Lab Clin Med 66:161-167, 1965;.
Kirkegaard C, Friis T, Siersbaek-Nielsen K:  Measurements of serum triiodothyronine by radioimmunoassay . Acta Endocrinol 77:71-81, 1974;.
Lauridsen UB, Deckert T, Friis T, et al:  Estimation of serum thyrotropin (TSH) and stimulation with thyrotropin-releasing hormone (TRH) in thyroid diseases . Acta Med Scand 196:171-176, 1974;.
Takahashi S, Kondo H, Yoshimura M, et al:  Thyrotropin responses to TRH in depressive illness: Relation to clinical subtypes and prolonged duration of depressive episode . Folia Psychiatr Neurol Jap 28:355-365, 1974;.
Takahashi S, Kondo H, Yoshimura M, et al:  Thyroid function levels and thyrotropin responses to TRH administration in manic patients receiving lithium carbonate . Folia Psychiatr Neurol Jap 29:231-237, 1975;.
Burg W van den, Praag HM van, Bos ERH, et al:  Thyrotropin releasing hormone (TRH) as a possible quick-acting but short-lasting anti-depressant . Psychol Med 5:404-412, 1975;.
Chopra IJ, Chopra U, Smith SR, et al:  Reciprocal changes in serum concentrations of 3,3', 5'-triiodothyronine (reverse T,) and 3,3'5-triiodothyronine (T,) in systemic illnesses . J Clin Endocrinol Metab 41:1043-1049, 1975;.
Besses GS, Burrow GN, Spaulding SW, et al:  Dopamine infusion acutely inhibits the TSH and prolactin response to TRH . J Clin Endocrinol Metab 41:985-988, 1975;.
Horn AS, Snyder SH:  Chlorpromazine and dopamine: Conformational similarities that correlate with the antischizophrenic activity of phenothiazine drugs . Proc Natl Acad Sci USA 68:2325-2328, 1971;.
Jarvik ME:  Drugs used in the treatment of psychiatric disorders , in Goodman LS, Gilman A (eds): The Pharmacological Basis of Therapeutics , ed 4. New York, Macmillan Co, 1970;, pp 169-170.
Paracchi A, Ferrari C, Faglia G:  Catecholaminergic and serotonergic influences on thyrotropin secretion in man . Acta Endocrinol 199( (suppl) ):316, 1975;.

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