[The effect of a single electroconvulsive shock on pituitary-thyroid-adrenal-gonadal axis function in men with severe depression--preliminary report]

Abstract

Introduction and aim: Electroconvulsive therapy (ECT) is an effective treatment of severe depression but its mechanism of action is still unknown. The aim of the study was to investigate the effect of first ECT on serum hormone concentrations in patients with severe depression.

Material and method: Serum concentrations of prolactin (PRL), adrenocorticotropin (ACTH), thyrotrophin (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol (F), triiodothyronine (T3), thyroxine (T4), estradiol (E2), progesterone (P) and testosterone (T) were estimated by RIA or IRMA in 5 men (mean age 34.20 +/- 8.70 years) with severe depression. Before ECT, all men were receiving psychotropic medication. None of the patients had clinical symptoms of endocrine disorders. Blood samples for hormonal investigations were taken before and 15 min., 2 hours, 6 h, 12 h, 24 h after the first electroconvulsive shock. The men without endocrine dysfunction in the same range of age who underwent identical intravenous anaesthesia for minor maxillofacial surgery were studied as controls.

Results: Before and after first ECT mean serum LH, T and T3 concentrations were significantly decreased and PRL, F and E mean levels were significantly elevated in men with depression as compared with the control group. No significant changes in mean serum hormone concentrations after ECT as compared to levels before ECT were observed.

Conclusion: (1) Single electroconvulsive shock insignificantly changes the pituitary-thyroid-adrenal-gonadal axis function. (2) Complicated hormonal changes found before electroconvulsive shock in patients with severe depression suggest the influence of psychotropic treatment as well as the illness on the endocrine system.