Abstract
Background: The hypothalamic neuropeptide arginine vasopressin is thought to play
an important role in the pathophysiology of affective disorders and the hyperactivity
of the hypothalamic–pituitary–adrenocortical system that frequently accompanies them.
Postmortem studies as well as clinical investigations have described elevated levels
of vasopressin in the brain and plasma of depressed patients, and this finding has
been suggested to contribute to depressive symptomatology.
Methods: The case of a 47-year-old patient displaying chronically elevated plasma
vasopressin levels due to paraneoplastic vasopressin secretion by an olfactory neuroblastoma
and the first episode of major depression is presented.
Results: Depressive symptoms improved markedly after surgical resection of the tumor
and subsequent normalization of plasma vasopressin levels. Unexpectedly, neither corticotropin
nor cortisol secretion could be stimulated by an intravenous corticotropin-releasing
hormone challenge under the condition of chronically elevated plasma vasopressin levels
in this patient.
Conclusions: Chronically elevated plasma vasopressin levels may induce depressive
symptomatology, and—in contrast to the potent corticotropin secretagogue effects of
acute vasopressin administration—lead to a marked desensitization of the hypothalamic–pituitary–adrenocortical
system.
Keywords
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Article info
Publication history
Accepted:
March 28,
2000
Received in revised form:
March 10,
2000
Received:
January 6,
2000
Identification
Copyright
© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
