EFFECTS OF NOCTURNAL TRH ADMINISTRATION ON TSH, MOOD, AND MOTOR ACTIVITY

清晨睡眠不足一晚(PSD： 患者清醒0200-2100小时)会产生急性但短暂的 超过60%的双相情感受试者有抗抑郁反应。直到最近， PSD几乎没有显示出临床效用，因为它的影响在48小时内减弱 几个小时。然而，现在已经有四项研究证明，同时存在的锂 治疗维持睡眠剥夺的急性抗抑郁作用 无限期，无杂环引起的躁狂风险。 虽然有效，但睡眠剥夺是麻烦的；患者经常 持怀疑态度，并说服他们接受它，或继续它一次 开始，是困难的。 然而，如果我们了解调解因素，我们或许能够 绕过睡眠剥夺，代之以管理调解人。这个 下丘脑-甲状腺轴(HPT)可能就是这样一种介体。夜间促甲状腺激素 双相抑郁患者的分泌减少，并随着 治疗成功。PSD会增加TSH，并增加TSH水平 睡眠不足与抗抑郁作用有关。促甲状腺激素 对患有抑郁症的患者产生急性但短暂的抗抑郁作用 抑郁症。关于急性疾病的描述之间的相似之处 PSD和TRH的一过性抗抑郁作用显著。我们 假设睡眠不足的反需求效应是由于 下丘脑或垂体水平的HPT刺激。我们会 对躁郁症患者在清晨服用TRH或安慰剂 确定抑郁受试者对促甲状腺激素、情绪和运动活动的影响。 我们预测，TRH将增加夜间TSH水平，并产生同样的- 一天，但短期内，情绪和运动量会增加。 我们希望利用这项研究得出的数据作为初步数据，以便 开展一项关于HPT轴、抗抑郁药和 锂/PSD和锂/TRH在双相情感障碍中的运动效应。

One night of sleep deprivation during the early morning hours (PSD: patient awake 0200-2100 hours) produces an acute, but transient antidepressant response in over 60% of bipolar subjects. Until recently, PSD has shown little clinical utility because its effects wane within 48 hours. However, four studies have now documented that concurrent lithium treatment maintains the acute antidepressents effects of sleep deprivation indefinitely, void of heterocyclic-induced mania risk. While effective, sleep deprivation is cumbersome; patients are often skeptical and persuading them to undergo it, or continue with it once begun, is difficult. If, however we understood the mediating factors, we might be able to bypass sleep deprivation and administer the mediator instead. The hypothalmic-thyroid axis (HPT) may be such a mediator. Nocturnal TSH secretion is reduced in bipolar depression and normalizes with successful treatment. PSD increases TSH and increases in TSH levels during sleep deprivation correlate with antidepressant effect. TSH produces an acute, but transient, antidepressant effect in patients with depression. The similarities between the descriptions of the acute, but transient, antidepressant effects of PSD and TRH are striking. We postulate that the antideressant effects of sleep deprivation are due to HPT stimulation at the level of the hypothalalmus or pituitary. We will administer TRH or placebo during the early morning hours to bipolar depressed subjects to determine effects on TSH, mood, and motor activity. We predict that TRH will increase nocturnal TSH levels and produce same- day, but short-term, increases in mood and locomotion. We hope to use the data derived from this study as initial data for developing a prospective study of the HPT axis, antidepressant, and locomotor effects of lithium/PSD and lithium/TRH in bipolar illness.