Journal article
Effects of Two Selective Serotonin Reuptake Inhibitor Antidepressants, Sertraline and Escitalopram, on Aldosterone/Renin Ratio in Normotensive Depressed Male Patients
Journal of Clinical Endocrinology and Metabolism, Vol.96(4), pp.1039-1045
2011
PMID: 21289246
Abstract
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.
Details
- Title
- Effects of Two Selective Serotonin Reuptake Inhibitor Antidepressants, Sertraline and Escitalopram, on Aldosterone/Renin Ratio in Normotensive Depressed Male Patients
- Authors
- Ashraf H Ahmed (Author) - University of QueenslandMichele Calvird (Author) - Queensland HealthRichard D Gordon (Author) - University of QueenslandPaul J Taylor (Author) - University of QueenslandGregory Ward (Author) - Sullivan Nicolaides PathologyEduardo Pimenta (Author) - Sullivan Nicolaides PathologyRoss Young (Author) - Queensland University of TechnologyMichael Stowasser (Author) - University of Queensland
- Publication details
- Journal of Clinical Endocrinology and Metabolism, Vol.96(4), pp.1039-1045
- Publisher
- Oxford University Press
- DOI
- 10.1210/jc.2010-2603
- ISSN
- 1945-7197
- PMID
- 21289246
- Organisation Unit
- Office of the Deputy Vice-Chancellor (Research and Innovation); University of the Sunshine Coast, Queensland
- Language
- English
- Record Identifier
- 99550997902621
- Output Type
- Journal article
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