[Clinical effects of cortisol synthesis inhibition on treatment-resistant depression].
Clinical trial with a steroid suppressive agent, metyrapone, was carried out in 6 patients with treatment-resistant depression (3 patients with major depression and 3 with bipolar disorder). Up to 2,000 mg/day of metyrapone was administered for 4 weeks, and 10 trials of the therapy were done in these patients. Most patients completed the therapy without remarkable side effects. As a result, three patients (6 trials) showed remission within 4 weeks and one patient (one trial) showed a partial response. In the remitted patients, plasma cortisol levels were suppressed below 10 micrograms/dl during the therapy and plasma ACTH levels were elevated. These results indicate that "hypercortisolemia-induced depression" similar to Cushing's disease may be present in patients with treatment-resistant depression.
Iizuka
H
H
Department of Neuro-Psychiatry, Faculty of Medicine, Tottori University, Yonago, Japan.
Kishimoto
A
A
Nakamura
J
J
Mizukawa
R
R
D000308:Adrenocortical Hyperfunction / Q000150:complications / Q000188:drug therapy; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D003864:Depression, Chemical; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008797:Metyrapone / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone; D008797:Metyrapone