CSF thyrotropin-releasing hormone concentrations differ in patients with schizoaffective disorder from patients with schizophrenia or mood disorders

Objective: To determine if there were differences in CSF-TRH concentrations among several acute major psychiatric disorders and to investigate the eff ects of antipsychotic treatment on CSF-TRH levels. Method: CSF-TRH concentr ations were measured in 62 psychiatric inpatients during an acute phase of illness after a drug-free period. CSF-TRH measurements were repeated in 14 of these patients after 4 weeks of antipsychotic treatment. Results: Post-h oc tests (Tukey HSD) revealed significant differences among patients with s chizoaffective disorder and both schizophrenia (P < 0.03) and major depress ion (P < 0.01). There were no significant differences between pre and postt reatment levels of CSF-TRH in the 14 patients treated with conventional age nts for 4 weeks (1.54 pg/ml vs. 1.47 pg/ml). However, patients with a reduc tion in CSF-TRH concentration had a significantly beater symptom response m easured by the Brief Psychiatric Rating Scale (BPRS) positive factor (61% i n six subjects) vs. those who had an increase in posttreatment CSF-TRH (29% in eight subjects: t = 2.2: d.f. = 12: P < 0.04). Conclusions: These resul ts provide further evidence for a neuromodulatory role for TRH and suggest a re-examination of its behavioral effects and interactions with brain neur otransmitter systems relevant to major psychotic and mood disorders. (C) 20 01 Elsevier Science Ltd. All rights reserved.