title: Electroconvulsive therapy for iatrogenic hypothalamic-hypopituitarism (CRF-ACTH type).
abstract: A 41-year-old man with hypothalamic hypopituitarism (CRF-ACTH type) that persisted for 2 years after discontinuation of exogenous dexamethasone was treated with bilateral ECT for severe chronic depression. The depression improved only evanescently after 17 ECT sessions but the hypothalamic-pituitary suppression cleared completely and permanently, based on responses to four metyrapone stress tests in a 2-year follow-up period. ECT may be an effective treatment for persistent hypothalamic-pituitary suppression, even in the absence of a psychiatric disorder.
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D002908:Chronic Disease; D003346:Corticotropin-Releasing Hormone / Q000097:blood*; D003863:Depression / Q000628:therapy; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D007018:Hypopituitarism / Q000628:therapy*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007049:Iatrogenic Disease; D008297:Male; D013375:Substance Withdrawal Syndrome / Q000628:therapy
chemical_list: D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone