Hypothalamic-pituitary-adrenal axis early-feedback responses are preserved in melancholic depression: a study of sertraline treatment.
Major depression with melancholia is associated with hypercortisolaemia. Loss of the early-phase of negative feedback - acute suppression of ACTH in response to rising cortisol levels - is the subject of conflicting reports in patients with major depression. Using a within-subjects design, six patients with DSM-IIIR melancholic depression received a 60 min infusion of hydrocortisone at 0900 with measurement of ACTH and cortisol before and after 4 weeks of antidepressant treatment. All patients responded clinically. ACTH responses (early feedback) did not differ between test conditions. Baseline cortisol fell significantly following treatment response. This provides further evidence for the preservation of the acute phase of negative feedback, even in the presence of hypercortisolism. Copyright 2000 John Wiley & Sons, Ltd.
Cooney
J. M.
JM
Guy's, King's & St Thomas's Medical School, Ladywell Unit, Lewisham Hospital, London, SE13 6LH, UK.
Dinan
T. G.
TG