Antidepressant treatment and dehydroepiandrosterone sulfate: Different effects of amitriptyline and paroxetine

Background: There is evidence for activation of the hypothalamus-pituitary- adrenal system in depressed patients to be associated with increased secretion of adrenal androgens. However, there is only limited information about the effect of different classes of antidepressants on the course of adrenal androgens. Methods: Dehydroepiandrosterone sulfate (DHEA-S) serum concentrations were measured in 80 patients being treated with amitriptyline (AMI) or paroxetine (PAROX) for a period of 35 days. Results: Using analysis of variance with repeated measures, we found a significant effect of treatment upon DHEA-S serum concentrations that declined more in AMI-treated (before vs. after: 1.89 ± 1.16 vs. 1.46 ± 0.96 mg/l), compared to PAROX-treated patients (1.56 ± 1.09 vs. 1.50 ± 1.04 mg/l). Conclusions: Our results show changes in DHEA-S serum concentrations during antidepressant treatment to depend on medication.