Ebook Dhea in human health and aging: Part 2
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Ebook Dhea in human health and aging: Part 2
■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2.............239Depressive Disorder...............................................................239Dementia..........................................................................242Schizophrenia.....................................................................244Anxiety...................... Ebook Dhea in human health and aging: Part 2.....................................................245Aggressive Behavior...............................................................246Mania....Ebook Dhea in human health and aging: Part 2
.........................................................................246Summary...................................................................■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2............................247INTRODUCTIONDehydroepiandrosterone (DHEA) and its sulfate ester. dehydroepiandrosterone sulfate (DHEAS), modulate several neurotransmitter systems (Maningcr el al. 2009: Perez-Neri cl al. 2008) involved in the pathophysiology of psychiatric disorders such as depression Ebook Dhea in human health and aging: Part 2, dementia, schizophrenia, anxiety. and mania. Some studies have found an association between endogenous DUE A levels and the incidence and course ofEbook Dhea in human health and aging: Part 2
those mental disorders. Also, several controlled clinical trials have reported beneficial effects of DI IE A administration.In spite of an increasing ■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2nce regarding the possible role of DHEA and DHEAS in psychiatric disorders.DEPRESSIVE DISORDERMajor depressive disorder is one of the most devastating mental diseases (Alexopoulos and Kelly Jr. 2009). Depressive symptoms include negative affect, sleep disturbance, feelings of guilt, and suicidal ide Ebook Dhea in human health and aging: Part 2ation, among others (Gotlib and Joormann 2010). Prevalence of depression throughout life has been estimated around 20% in some populations, and the raEbook Dhea in human health and aging: Part 2
le of relapse may be as high as 75% (Gotlib and Joormann 2010). The mechanism for antidepressant action is partially understood and a therapeutic resp■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2s. Plasma DHEA concentration was increased in depressed (Heuser et al. 1998) and psychotic depressed (Maayan et al. 2000) patients, but salivary (Eser et al. 2006b: Goodyer et al. 2001b: Michael et al. 2000) and urinary (Poor Ct al. 2004) levels were decreased in other studies. Decreased (Jozuka el Ebook Dhea in human health and aging: Part 2al. 2003: Maninger el al. 2009; Morgan cl al. 2010) and unchanged (Kahl et al. 2006; Maninger et al. 2009: Young. Gallagher, and Porter 2002) blood DIEbook Dhea in human health and aging: Part 2
IEA levels have also been reported.239240DHEA in Human Health and AgingChanges in DHEA and DHEAS salivary and blood concentrations are relevant to cen■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2t al. 1996): however, it is possible that the brain content of the steroids is differently altered or even unchanged in spite of a different level in the extracellular environment. In fact. DHEA content in cingulate and parietal cortices from depressed patients was not significantly different from c Ebook Dhea in human health and aging: Part 2ontrols (Marx et al. 2006a). although other brain regions were not studied.DI IE A may be associated not only to the incidence of the disease, but alsEbook Dhea in human health and aging: Part 2
o to the severity of depressive symptoms. Morning salivary DHẼA levels were inversely correlated to the severity of depression in some studies (Eser e■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2(Fukai et al. 2009). or psychotic depressed patients (Maayan cl al. 2000).Moreover, it is possible that salivary DHEA concentration is not altered by the chronicity of the disease because it was not different in boys with chronic major depression compared with those who recovered from a depressive e Ebook Dhea in human health and aging: Part 2pisode (Goodyer. Park, and Herbert 2001a). Thus. DIIEA may be altered from the first depressive episode and remain altered throughout the course of thEbook Dhea in human health and aging: Part 2
e disease independently of remission. This hypothesis is supported by the lack of association between steroid levels and the effect of antidepressants■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2ents (Padbcrg cl al. 2002). However, low DHEA levels were associated with the antidepressant effect of sleep deprivation (Schtile et al. 2003).The role of DI IE A as the cause or the consequence of depression remains a matter of debate. Changes in steroid levels should be found before the disease on Ebook Dhea in human health and aging: Part 2set if ii is involved in the development of the disorder. However, changes in DHEA concentration were absent before the onset of major depression. AlsEbook Dhea in human health and aging: Part 2
o, steroid levels were not significantly correlated to mood scores in adolescents al high risk of developing depressive disorders (Gixxlycr el al. 200■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 200a). However, those results may be influenced by the fact that not every high-risk case will finally develop depressive illness (Goodyer et al. 2000a). Actually, an increased DHEA concentration al baseline was significantly associated to the onset of major depression in adolescents al follow-up (Go Ebook Dhea in human health and aging: Part 2odycr el al. 200()a.b. 2001b). although this result was not replicated in adults (Harris et al. 2000).Even if an altered DHEA concentration is the cauEbook Dhea in human health and aging: Part 2
se or the consequence of depressive disorders, an increasing body of evidence supports a therapeutic effect of the steroid. Several studies have found■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 206: Dubrovsky 2005: Eser et al. 2006a: Maninger el al. 2009: Ravindran cl al. 2009: Schmidt cl al. 2005) or psychological wellbeing (Brooked al. 2006: Dubrovsky 2005; Maningerel al. 2009: Nawalact al. 2002: Schumacher et al. 2003). In placebo-controlled, double-blind clinical trials. DIIEA administr Ebook Dhea in human health and aging: Part 2ation to healthy subjects improves mood (Aril el al. 1999). The steroid reduces symptom severity in depressed patients (Bloch el al. 1999: Eser et al.Ebook Dhea in human health and aging: Part 2
2006b: Schmidt et al. 2005: Wolkovvilz el al. 1999). and this effect also occurs in other diseases such as adrenal insufficiency (Binder et al. 2009:■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2 some studies have failed to replicate those results (Aril el al. 2001; Krilz-Silvcrsicin et al. 2008). but it should be noted that increased blood DHEAS levels were associated to an antidepressant response after DHEA treatment (Bloch et al. 1999: Rabkin el al. 2006); thus, the failure to increase D Ebook Dhea in human health and aging: Part 2HEAS (and possibly DHEA) levels in some patients may be responsible for the absence of a clinical response to DHEA supplementation.Regarding DHEAS. itEbook Dhea in human health and aging: Part 2
is possible that reduced levels of Illis steroid favor the development of a depressive episode. Low DHEAS concentration is associated lo an enhanced ■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2Assies Cl al. 2004: Maningcrel al. 2009) and urinary (Eserct al. 2006b) concentrations were reported in depressed patients. Some authors have reported reduced DHEAS concentration in patients with depression (Eser et al. 2006b; Maninger et al. 2009) or dysthymia (Markianos et al. 2007). No difference Ebook Dhea in human health and aging: Part 2 in DHEAS plasma levels was found in other studies (Jozuka el al. 2003: Paslakis et al. 20I0).Supporting the role of DHEAS deficiency in depression, tEbook Dhea in human health and aging: Part 2
he steroid was inversely correlated to the severity of depressive symptoms according to some studies (Brzoza et al. 2008: Haren et al. 2007: Maninger ■j Q The Role of DHEA in Mental DisordersIván Pérez-Neri and Camilo RiosCONTENTSIntroduction.......................................................... Ebook Dhea in human health and aging: Part 2l al. 2009). Also. DHEAS levels were positively correlated to mood scores, showing a better sense of well-being at increased steroid concentration (Valtysdottir. Wide, and Hallgren 2003). Depressive symptomatology in elderly women was associated lo low DHEAS levels (Herr cl al. 1996».Even though an Ebook Dhea in human health and aging: Part 2increased DHEA.S concentration following DHEA administration is associated with an antidepressant response (Bloch et al. 1999: Rabkin et al. 2006). anEbook Dhea in human health and aging: Part 2
increased baseline level may interfere with that effect. Depressed patients with high DIIEAS levels do not respond to elec-troconv ulsivc therapy (EsGọi ngay
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