Oestrogen-stimulated neurophysin and outcome after electroconvulsive therapy

Plasma concentrations of oestrogen-stimulated neurophysin (ESN), prolactin, and growth hormone were measured before and after the first treatment in a course of electroconvulsive therapy (ECT) given to 25 psychiatric patients and during induction of anaesthesia in 9 women undergoing elective cholecystectomy. Prolactin levels rose and growth hormone levels fell during both cholecystectomy and ECT, but ESN levels rose only after ECT. The peak ESN response to ECT was significantly greater (p less than 0.005) in the 16 depressed patients who recovered than in the 9 who did not. All patients in whom plasma ESN concentration increased by more than 100% satisfactorily recovered from their depressive illness. If a 63% increase in ESN concentration is used to classify all subjects, 12% are misclassified by outcome at 2 months. The extent of the ESN response, but not the prolactin or growth hormone responses, correlated with improvement in symptoms measured by Hamilton Rating Scale for Depression and the Montgomery and Asberg Depression Rating Scale.