Pivagabine decreases stress-related hormone secretion in women with hypothalamic amenorrhea

Stress-induced neuroendocrine activities influence the regulation of endocr ine glands and axes. Weight loss-related hypothalamic amenorrhea is a typic al stress-induced physiopathological condition. It is characterized by incr eased adrenal cortex activation and by reduced GH, LH, FSH and gonadal ster oid hormone levels. The aim of the present study was to investigate the eff ects of pivagabine, a neurotropic drug (1800 mg/day for 7 days) or placebo administration on ACTH, cortisol, GH, LH, FSH and PRL plasma levels in pati ents with hypothalamic amenorrhea related to weight loss. Hormonal paramete rs and the pulsatile release of cortisol (6-hour pulsatility, sampling ever y 10 minutes) were evaluated before and after 7 days of treatment. Pivagabi ne administration significantly reduced mean plasma ACTH (from 21.7+/-1.7 t o 15.4+/-1.2 pg/ml, p<0.05) and cortisol levels (from 12.2+/-0.7 to 9.7+/-0 .7 ng/ml, p<0.05) and increased GH levels (from 1.4+/-0.5 to 3.0+/-0.9 ng/m l, p<0.05). A significant reduction of cortisol pulse amplitude was observe d (p<0.01) while no change in pulse frequency occurred. No changes were obs erved in placebo-treated subjects. LH, FSH and PRL levels were not modified by placebo or pivagabine administration. In conclusion, in patients with h ypothalamic amenorrhea related to weight loss pivagabine induced a signific ant decrease of cortisol secretion and an increase of GH release by pivagab ine administration, suggesting that this drug exerts a specific neuroendocr ine modulatory role. (J. Endocrinol. Invest. 23: 526-532, 2000) (C) 2000, E ditrice Kurtis.