Low-dose dexamethasone challenge in women with atypical major depression: pilot study.
OBJECTIVE
To examine if atypical depression may be associated with hypersuppression of the hypothalamic-pituitary-adrenal (HPA) axis.


METHODS
Eight women with atypical major depression and 11 controls with no history of psychiatric illness, matched on age and body mass index, were challenged with low-dose dexamethasone (0.25 mg and 0.50 mg in random order and 1 week apart). Dexamethasone was self administered at 11 pm, and plasma cortisol samples were drawn at 8 am and 3 pm on the following day.


RESULTS
After the 0.50-mg dexamethasone challenge, mean suppression of morning cortisol was significantly greater in patients with atypical depression (91.9%, standard deviation [SD] 6.8%) than in the controls (78.3%, SD 10.7%; p < 0.01).


CONCLUSIONS
These preliminary data add to the growing body of literature that suggests atypical depression, in contrast to classic melancholia, may be associated with exaggerated negative feedback regulation of the HPA axis.
Levitan
Robert D
RD
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont. Robert_Levitan@camh.net
Vaccarino
Franco J
FJ
Brown
Gregory M
GM
Kennedy
Sidney H
SH
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology; D015992:Body Mass Index; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D003907:Dexamethasone / Q000008:administration & dosage / Q000494:pharmacology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D010865:Pilot Projects; D010913:Pituitary-Adrenal System / Q000503:physiopathology
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D006854:Hydrocortisone