The effect of escitalopram versus placebo on perceived stress and salivary cortisol in healthy first-degree relatives of patients with depression-A randomised trial

TY - JOUR

T1 - The effect of escitalopram versus placebo on perceived stress and salivary cortisol in healthy first-degree relatives of patients with depression-A randomised trial

AU - Knorr, Ulla

AU - Vinberg, Maj

AU - Gether, Ulrik

AU - Winkel, Per

AU - Gluud, Christian

AU - Wetterslev, Jørn

AU - Kessing, Lars Vedel

N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PY - 2012/12/30

Y1 - 2012/12/30

N2 - The effect of selective serotonin reuptake inhibitors (SSRI) on healthy individuals remains unclear. We tested the hypothesis that escitalopram decreases perceived stress and salivary cortisol. The trial has a randomised, blinded, placebo-controlled, parallel-group design. After informed consent 80 healthy first-degree relatives to patients with depression were randomly allocated to receive daily tablets of escitalopram 10mg or placebo for 4 weeks. The area under the curve (AUC) for awakening and all day salivary cortisol was analysed in samples taken immediately after awakening and at 15-min intervals for the next hour, and at 12:00, 18:00 and 23:00. The salivary cortisol awakening response, all day salivary cortisol, and scale scores on sleep, pain, aggression, quality of life, and perceived stress assessed at entry were compared to values following 4 weeks of intervention. Statistically significant decreases were found in awakening salivary cortisol (P=0.04) and in all day salivary cortisol (P=0.02) in the escitalopram group compared with the placebo group. There were no statistically significant differences in perceived stress between the intervention groups. These findings from a randomised clinical trial suggest that a long-term escitalopram administration to healthy participants results in a decrease in the hypothalamic-pituitary-adrenal (HPA) activity measured by salivary cortisol compared with inert placebo. However, change in salivary cortisol was one out of multiple outcome measures. The results of the present trial do not refute salivary cortisol as a potential endophenotype for depression.

AB - The effect of selective serotonin reuptake inhibitors (SSRI) on healthy individuals remains unclear. We tested the hypothesis that escitalopram decreases perceived stress and salivary cortisol. The trial has a randomised, blinded, placebo-controlled, parallel-group design. After informed consent 80 healthy first-degree relatives to patients with depression were randomly allocated to receive daily tablets of escitalopram 10mg or placebo for 4 weeks. The area under the curve (AUC) for awakening and all day salivary cortisol was analysed in samples taken immediately after awakening and at 15-min intervals for the next hour, and at 12:00, 18:00 and 23:00. The salivary cortisol awakening response, all day salivary cortisol, and scale scores on sleep, pain, aggression, quality of life, and perceived stress assessed at entry were compared to values following 4 weeks of intervention. Statistically significant decreases were found in awakening salivary cortisol (P=0.04) and in all day salivary cortisol (P=0.02) in the escitalopram group compared with the placebo group. There were no statistically significant differences in perceived stress between the intervention groups. These findings from a randomised clinical trial suggest that a long-term escitalopram administration to healthy participants results in a decrease in the hypothalamic-pituitary-adrenal (HPA) activity measured by salivary cortisol compared with inert placebo. However, change in salivary cortisol was one out of multiple outcome measures. The results of the present trial do not refute salivary cortisol as a potential endophenotype for depression.

KW - Adult

KW - Aggression

KW - Antidepressive Agents, Second-Generation

KW - Citalopram

KW - Depressive Disorder

KW - Family

KW - Female

KW - Humans

KW - Hydrocortisone

KW - Hypothalamo-Hypophyseal System

KW - Male

KW - Middle Aged

KW - Pituitary-Adrenal System

KW - Quality of Life

KW - Saliva

KW - Sleep

KW - Stress, Psychological

U2 - 10.1016/j.psychres.2012.05.015

DO - 10.1016/j.psychres.2012.05.015

M3 - Journal article

C2 - 22703642

SN - 1178-6183

VL - 200

SP - 354

EP - 360

JO - Psychiatry Research Review

JF - Psychiatry Research Review

IS - 2-3

ER -