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Effects of Two Selective Serotonin Reuptake Inhibitor Antidepressants, Sertraline and Escitalopram, on Aldosterone/Renin Ratio in Normotensive Depressed Male Patients

Administration of two selective serotonin reuptake inhibitors was associated with a reduction in the plasma aldosterone/renin ratio, suggesting that this class of antidepressants can increase the risk of false negative results when screening for primary aldosteronism. Background: Plasma aldosterone... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2011, Vol.96 (4), p.1039-1045
Main Author: Ahmed, Ashraf H
Other Authors: Calvird, Michele , Gordon, Richard D , Taylor, Paul J , Ward, Gregory , Pimenta, Eduardo , Young, Ross , Stowasser, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Bethesda, MD: Endocrine Society
ID: ISSN: 0021-972X
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recordid: cdi_proquest_miscellaneous_861202655
title: Effects of Two Selective Serotonin Reuptake Inhibitor Antidepressants, Sertraline and Escitalopram, on Aldosterone/Renin Ratio in Normotensive Depressed Male Patients
format: Article
creator:
  • Ahmed, Ashraf H
  • Calvird, Michele
  • Gordon, Richard D
  • Taylor, Paul J
  • Ward, Gregory
  • Pimenta, Eduardo
  • Young, Ross
  • Stowasser, Michael
subjects:
  • Abridged Index Medicus
  • Adult
  • Aldosterone - blood
  • Aldosterone - metabolism
  • Antidepressive Agents - pharmacology
  • Antidepressive Agents - therapeutic use
  • Biological and medical sciences
  • Blood Pressure - drug effects
  • Blood Pressure - physiology
  • Citalopram - pharmacology
  • Citalopram - therapeutic use
  • Depression - blood
  • Depression - drug therapy
  • Depression - physiopathology
  • Depression - urine
  • Endocrinopathies
  • Feeding. Feeding behavior
  • Fundamental and applied biological sciences. Psychology
  • Humans
  • Hydrocortisone - blood
  • Hyperaldosteronism - blood
  • Hyperaldosteronism - diagnosis
  • Male
  • Medical sciences
  • Renin - blood
  • Renin - metabolism
  • Renin-Angiotensin System - drug effects
  • Serotonin Uptake Inhibitors - pharmacology
  • Serotonin Uptake Inhibitors - therapeutic use
  • Sertraline - pharmacology
  • Sertraline - therapeutic use
  • Time Factors
  • Vertebrates: anatomy and physiology, studies on body, several organs or systems
  • Vertebrates: endocrinology
ispartof: The journal of clinical endocrinology and metabolism, 2011, Vol.96 (4), p.1039-1045
description: Administration of two selective serotonin reuptake inhibitors was associated with a reduction in the plasma aldosterone/renin ratio, suggesting that this class of antidepressants can increase the risk of false negative results when screening for primary aldosteronism. Background: Plasma aldosterone to renin ratio (ARR) is the most popular screening test for primary aldosteronism (PAL). Certain medications are known to cause false-negative or -positive ARRs by affecting renin and aldosterone levels. There are no previously published data on the effects of antidepressants on ARR. Methods: Normotensive, depressed male patients (n = 26) underwent measurement (seated, midmorning) of plasma aldosterone, direct renin concentration (DRC), renin activity (PRA), electrolytes and creatinine and urinary aldosterone, cortisol, electrolytes, and creatinine at baseline and after 2 and 6 wk treatment with sertraline (n = 14) or escitalopram (n = 12). Results: For both antidepressants, treatment was associated with rises in aldosterone [sertraline: baseline, mean ± sd, 243 ± 34; 2 wk, 256 ± 33; 6 wk, 267 ± 34 pmol/liter (P < 0.01 by ANOVA); escitalopram, 261 ± 36, 269 ± 38, 282 ± 40 pmol/liter (P < 0.05)], DRC [19.5 ± 2.2, 33.5 ± 2.0, 39.0 ± 2.4 mU/liter (P < 0.001); 24.5 ± 2.4, 34.0 ± 2.7, 42.8 ± 2.4 mU/liter (P < 0.001)], and PRA [2.24 ± 0.21, 2.58 ± 0.26, 4.68 ± 0.42 ng/ml · h (P < 0.001); 4.31 ± 0.22, 5.57 ± 0.36, 6.42 ± 0.53 ng/ml · h (P < 0.001)]. ARR fell significantly whether calculated using DRC [sertraline, 13.7 ± 2.2, 7.5 ± 0.7, 6.8 ± 0.7 (P < 0.001); escitalopram, 11.5 ± 1.9, 8.0 ± 1.1, 6.6 ± 1.0 (P < 0.001)], or PRA [116.6 ± 15.8, 108.4 ± 15.6, 60.4 ± 6.2 (P < 0.001); 61.2 ± 8.1, 50.0 ± 7.7, 45.6 ± 6.0 (P < 0.01)]. Conclusion: Selective serotonin reuptake inhibitor antidepressants can significantly reduce ARR and therefore potentially increase the risk of false-negative results when screening for PAL. Further studies in hypertensive patients, including patients with confirmed PAL, are required.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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creatorAhmed, Ashraf H ; Calvird, Michele ; Gordon, Richard D ; Taylor, Paul J ; Ward, Gregory ; Pimenta, Eduardo ; Young, Ross ; Stowasser, Michael
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subjectAbridged Index Medicus ; Adult ; Aldosterone - blood ; Aldosterone - metabolism ; Antidepressive Agents - pharmacology ; Antidepressive Agents - therapeutic use ; Biological and medical sciences ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Citalopram - pharmacology ; Citalopram - therapeutic use ; Depression - blood ; Depression - drug therapy ; Depression - physiopathology ; Depression - urine ; Endocrinopathies ; Feeding. Feeding behavior ; Fundamental and applied biological sciences. Psychology ; Humans ; Hydrocortisone - blood ; Hyperaldosteronism - blood ; Hyperaldosteronism - diagnosis ; Male ; Medical sciences ; Renin - blood ; Renin - metabolism ; Renin-Angiotensin System - drug effects ; Serotonin Uptake Inhibitors - pharmacology ; Serotonin Uptake Inhibitors - therapeutic use ; Sertraline - pharmacology ; Sertraline - therapeutic use ; Time Factors ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology
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authorAhmed, Ashraf H ; Calvird, Michele ; Gordon, Richard D ; Taylor, Paul J ; Ward, Gregory ; Pimenta, Eduardo ; Young, Ross ; Stowasser, Michael
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4Antidepressive Agents - pharmacology
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19Hydrocortisone - blood
20Hyperaldosteronism - blood
21Hyperaldosteronism - diagnosis
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23Medical sciences
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25Renin - metabolism
26Renin-Angiotensin System - drug effects
27Serotonin Uptake Inhibitors - pharmacology
28Serotonin Uptake Inhibitors - therapeutic use
29Sertraline - pharmacology
30Sertraline - therapeutic use
31Time Factors
32Vertebrates: anatomy and physiology, studies on body, several organs or systems
33Vertebrates: endocrinology
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