5-HT1 and 5-HT2 receptor activation reduces N-methyl-D-aspartate (NMDA)-stimulated LH secretion in prepubertal male and female rats

Psychotropic medication use among women seeking assisted reproductive technology (ART) therapy: A cross-sectional study

Background Infertility is associated with increased anxiety, depressive symptoms and mood disorders. Unfortunately, mental health is not often addressed in infertility treatment and infertile patients could be at higher risk of self-administration of not prescribed drugs or/and be exposed to alternative emotional treatments. Therefore, the aim of the present study is to investigate the use of psychotropic medication and to evaluate the frequency of psychiatric diagnosis among infertile women seeking assisted reproductive technology (ART) therapy. Methods All infertile women starting treatment at an ART clinic who agreed to participate in the study were included. Patients were submitted to a structured psychiatric interview, the Mini International Neuropsychiatric Interview (M.I.N.I.). Current and lifetime use of psychotropic medication were assessed. Results Ninety patients who agreed to participate completed the research protocol.  A total of 12/90  were on current use of psychotropic medication.Thirty-six out of ninety patients  had at least one psychiatric disorder. Mood disorders were detected in 19 of the 90. Anxiety disorders were highly frequent, reaching 27/90 of the patients, as agoraphobia the most common diagnosis (12/90). Limitations The study has several limitations, such as the absence of a control group of fertile patients and strict inclusion criteria, in which only subjects that spontaneously agreed to participate were enrolled. Conclusion Women suffering from infertility seeking ART treatment are at high risk for depression and anxiety disorders and a considerable number of them are in use of medication. Its implications on infertility treatments and offspring are uncertain.

Fluoxetine treatment of prepubertal male rats uniformly diminishes sex hormone levels and, in a subpopulation of animals, negatively affects sperm quality

Fluoxetine (Flx) is a selective serotonin reuptake inhibitor that alters the male reproductive system when administered at the adult stage or after maternal exposure. In the present study we evaluated the effects of Flx administration on reproductive parameters during juvenile–peripubertal development when treated male rats reached adulthood. Groups of rats were treated daily with Flx (5 mg kg−1, i.p.) or saline (0.9% NaCl), or were left untreated. Rats were treated between 30 and 53 days of age and were killed at 65 days of age. Serotonin concentrations were determined in the hypothalamus, hypophysis and testis. Gonadotrophins, sex steroids and sperm quality (membrane integrity, sperm with functional mitochondria, sperm density, sperm motility and morphological abnormalities) were also evaluated. Flx did not affect bodyweight, but significantly diminished LH, FSH, progesterone and testosterone serum concentrations. After graphical analysis, a subgroup of rats was identified whose sperm quality parameters were greatly affected by Flx. In the present study we show that Flx administered to juvenile rats disrupts the hypothalamic–hypophyseal–testicular axis and its effects on sperm quality are not homogeneous in adults. In contrast, Flx altered concentrations of gonadotrophins and sexual steroids in all treated rats. These results suggest caution should be exercised in the prescription of Flx to prepubertal males.

Pargyline effect on luteinizing hormone secretion throughout the rat estrous cycle: Correlation with serotonin, catecholamines and nitric oxide in the medial preoptic area

The neurons that produce gonadotrophin-releasing hormone (GnRH) are mainly found in the medial preoptic area (MPOA) and constitute a common final pathway to the control of luteinizing hormone (LH) surge on proestrus. The control of GnRH secretion depends on several neurotransmitters, such as serotonin (5-HT), noradrenaline (NA), dopamine (DA) and nitric oxide (NO). The aim of this work was to study the profile of 5-HT, catecholamines and their main metabolites in the MPOA throughout the estrous cycle and their interactions with NO system in this area to control LH surge. For this purpose, the following were evaluated: (I) the effect of pargyline (a monoamine oxidase inhibitor) acute treatment on plasma LH secretion throughout the estrous cycle, correlated with changes of 5-HT, DA and NA content as well as activity and expression of neuronal NO synthase (nNOS) within MPOA; (II) the effect of 5,7-dihydroxitriptamine (a drug that depletes 5-HT) microinjection into MPOA on plasma LH in ovariectomized rats treated with oil, estradiol (E(2)) or E(2) plus progesterone (P(4)). Pargyline prevented LH surge on proestrus without altering its basal secretion. Throughout the estrous cycle, pargyline augmented both 5-HT and DA contents in approximately 300% and NA content in 50% in the MPOA. During proestrus, pargyline stimulated nNOS activity at 9 h and inhibited it at 11 h. nNOS expression was inhibited by pargyline at 15 h. Depletion of 5-HT content in the MPOA increased LH secretion in ovariectomized rats treated with E(2) plus P(4), but it did not modify in rats treated with either oil or E(2). Therefore, the present data show that pargyline treatment can inhibit proestrus LH surge through a mechanism that may involve 5-HT and NO systems in the MPOA. Moreover, the effect of 5-HT in the MPOA for limiting LH surge seems to depend on plasma levels of E(2) and P(4).

Night Sweats and Elevated Follicle-Stimulating Hormone Levels While Taking Selective Serotonin Reuptake Inhibitors

BACKGROUND

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to women with depression and anxiety disorders. Although night sweats are a reported adverse effect, some women have relief of vasomotor symptoms during perimenopausal period while taking them. The relationships between SSRIs, thermoregulation, gonadotropins, and estrogen and their connection to fertility remain unclear.

CASE

A reproductive-aged woman, seeking treatment for infertility, experienced night sweats and elevated follicle-stimulating hormone levels while taking SSRIs for treatment of depression.

CONCLUSION

Many women of reproductive age are taking SSRIs, but the affect of SSRIs on normal reproductive function is unknown and further research in this area is needed.

What is the evidence basis for existing treatments of eating disorders?

Most existing treatments of eating disorders (ED) produce a period of remission that is short lived and expressed in fewer than 50% of the patients. Antidepressants (eg, selective serotonin reuptake inhibitors [SSRI]) have a small effect in bulimia nervosa and they are not recommended in anorexia nervosa (AN) because serotonin inhibits food intake. In a randomized, controlled trial, training of eating behavior and satiety, supply of warmth, reduction of physical hyperactivity, and restoration of social activities brought 75% of patients with ED into remission, and 93% remained in remission during follow-up. Further randomized, controlled trials comparing presently used interventions will provide the evidence needed to improve the treatment of ED.