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Eur Neuropsychopharmacol. 2007 Sep;17(9):573-9. Epub 2007 Mar 7.

Reduced orexin levels in the cerebrospinal fluid of suicidal patients with major depressive disorder.

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  • 1Division of Psychiatry, Department of Clinical Sciences, Lund University, Kioskgatan 19, SE-221 85 Lund, Sweden.


Orexins are neuropeptides selectively expressed in a small number of neurons in the lateral-posterior hypothalamus. We measured orexin-A in the cerebrospinal fluid (CSF) of 66 patients with major depressive disorder (MDD), dysthymia and adjustment disorder after a suicide attempt. Blood samples confirmed that the patients were free from antidepressive and neuroleptic medication at the time of the lumbar punctures. CSF levels of orexin-A were significantly lower in patients with MDD than in patients with adjustment disorder and dysthymia. Orexin correlated significantly with CSF levels of somatostatin, delta sleep inducing peptide-like immunoreactivity (DSIP-LI) and corticotrophin releasing factor (CRF), but not with leptin or vasopressin. Plasma levels of thyroid-stimulating hormone (TSH) were not reduced in MDD patients, and did not correlate with CSF-orexin. Our results suggest that suicidal patients with MDD have distinct neurobiological features, involving compromised levels of hypothalamic peptides regulating the state of arousal.

2007 Elsevier B.V and ECNP

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