Effects of ECT course on TSH and prolactin responses to TRH in depressed patients

The thyrotropin (TSH) and prolactin (PRL) responses to TRH were studied in 15 female depressed patients with melancholia (nine unipolar, six bipolar) during an electroconvulsive therapeutic course. The test was performed before initiation of treatment, 5 days after the final ECT session, and 1 month later, when the patients were on medication with heterocyclic antidepressants (HCAs). The maximal hormonal responses were not altered 5 days after the final ECT but both increased significantly 1 month later. Responders (n = 8) and non-responders (n = 7) to ECT did not differ significantly as regards changes in delta max TSH and PRL. The seven non-responders to ECT improved markedly after 1 month's treatment with HCAs. Three out of four patients with blunted TSH response (less than 5 mu IU/ml) continued to exhibit a blunted response in both post-ECT TRH tests. The rank order of magnitude of delta max TSH remained remarkably stable throughout the assessment period as shown by the highly significant correlations between the values in the three time points.