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Pharmacopsychiatry 2006; 39(1): 23-29
DOI: 10.1055/s-2006-931476
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Renin-Angiotensin-Aldosterone System, HPA-Axis and Sleep-EEG Changes in Unmedicated Patients with Depression after Total Sleep Deprivation

H. Murck1 , 2 , M. Uhr1 , M. Ziegenbein1 , H. Künzel1 , K. Held1 , I. A. Antonijevic1 , P. Schüssler1 , A. Steiger1
  • 1Max-Planck-Institute of Psychiatry, Munich, Germany
  • 2Present Address: Amarin Neuroscience Ltd, FK7 9JQ Stirling, UK
Further Information

Publication History

Received: 27.4.2005 Revised: 12.5.2005

Accepted: 10.10.2005

Publication Date:
02 February 2006 (online)

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Background: Changes in the activity of the renin-angiontensin-aldosterone system (RAAS) in depression have recently been reported. Renin and aldosterone secretion are coupled to sleep in healthy subjects. As total sleep deprivation (TSD) leads to a rapid mood improvement in patients with depression, it is of interest to investigate its effect on the response of the RAAS in the recovery night in this population as a possible probe for the neurobiological effects of TSD and potentially other rapid acting antidepressive interventions. Additionally we explored the HPA-system and the sleep-EEG-changes. Methods: We compared the sleep related activity of the RAAS before and after TSD in seven depressed patients. After an accommodation night, a polysomnographic examination was performed between 23.00 h and 7.00 h. This was followed by 40 h of TSD and a second polysomnography. During the examination blood samples were taken in the night every 20 min for analysis of renin, aldosterone, ACTH and cortisol. Results: During recovery-sleep renin was significantly increased (p < 0.05). Aldosterone showed no change. ACTH and cortisol were decreased by trend in the first half of the night. REM-density and intermittent wakefulness was significantly decreased (p < 0.05), whereas slow wave sleep increased by trend in the first half of the night. Conclusion: TSD in patients with depression leads to an increase in renin secretion and a concomitant trend for a decrease in HPA axis activity in the recovery night. These changes could be a ”fingerprint” of a rapidly antidepressive treatment.

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