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Psychopharmacology (Berl). 2004 Jul;174(3):414-20. Epub 2004 Jan 20.

Quetiapine reduces nocturnal urinary cortisol excretion in healthy subjects.

Author information

1
Department of Psychiatry and Psychotherapy, Georg-August-University of Göttingen, von-Siebold Strasse 5, 37075 Göttingen, Germany. scohrs@gwdg.de

Abstract

RATIONALE:

Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is a frequent finding in psychiatric disorders, including psychotic depression and schizophrenia. Conflicting results exist concerning the influence of antipsychotics on the HPA-axis.

OBJECTIVE:

Therefore, this double-blind, placebo-controlled, randomized cross-over study investigated the effect of quetiapine on nocturnal urinary cortisol and melatonin excretion in 13 healthy male subjects under conditions of undisturbed and experimentally disturbed sleep.

METHODS:

Volunteers were studied 3 times for 3 consecutive nights (N0, adaptation; N1, standard sleep conditions; N2, acoustic stress) 4 days apart. Placebo, quetiapine 25 mg or quetiapine 100 mg was administered orally 1 h before bedtime on nights 1 and 2. Urine produced during the 8-h bedtime period was collected for later determination of cortisol and melatonin concentrations by standard radioimmunoassays.

RESULTS:

MANOVA showed a significant effect for N1 vs. N2 with elevated total amount of cortisol ( p<0.005) and melatonin ( p<0.05) excretion after acoustic stress. Both quetiapine 25 mg and 100 mg significantly ( p<0.0005) reduced the total amount of cortisol excretion in comparison to placebo. No interaction effect of stress condition was observed. There was no effect of quetiapine on melatonin levels.

CONCLUSION:

The significant reduction of nocturnal cortisol excretion following quetiapine reflects a decreased activity of the HPA-axis in healthy subjects. This finding may be an important aspect in quetiapine's mode of action in different patient populations.

PMID:
14735295
DOI:
10.1007/s00213-003-1766-6
[Indexed for MEDLINE]

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