Tolerability of the dexamethasone-corticotropin releasing hormone test in major depressive disorder.
BACKGROUND
The dexamethasone-corticotropin releasing hormone (Dex-CRH) test may differentially predict which depressed patients will respond to antidepressant medication. However, a comprehensive analysis of the safety of this test in psychiatric patients has not previously been performed.


METHODS
We conducted a pooled analysis of depressed patients in four clinical studies. Observed and subjectively reported side-effects in 454 patients were collected for 90 minutes following CRH administration. Pre-test electrocardiograms were available in 250 patients to assess cardiac safety. Descriptive statistics were performed to evaluate these safety data.


RESULTS
Eight-six (18.9%) subjects experienced no side-effects from the procedure. The mean number of side-effects per subject was 1.4±1.0. The most frequent adverse events were: flushing (n=216, 47.6%), feeling of warmth (144, 31.7%), hyperpnea/tachypnea (108, 23.8%), palpitations (37, 8.1%), and tachycardia (28, 6.2%). Side-effects were consistently mild and brief in duration. There were no serious adverse events.


CONCLUSIONS
The Dex-CRH test produces a mild, predictable side-effect profile, characterized by flushing, feelings of warmth, hyperpnea/tachypnea, palpitations, and tachycardia. These results provide reassurance that the Dex-CRH test is well tolerated in psychiatric patients.
Dunlop
Boadie W
BW
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1256 Briarcliff Road NE, Building A, 3rd Floor, Atlanta, GA 30322, USA. bdunlop@emory.edu
Betancourt
Yara
Y
Binder
Elisabeth B
EB
Heim
Christine
C
Holsboer
Florian
F
Ising
Marcus
M
McKenzie
Melissa
M
Mletzko
Tanja
T
Pfister
Hildegard
H
Nemeroff
Charles B
CB
Craighead
W Edward
WE
Mayberg
Helen S
HS
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D003865:Major Depressive Disorder / Q000097:blood / Q000175:diagnosis*; D003907:Dexamethasone; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome
D000928:Antidepressive Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D003346:Corticotropin-Releasing Hormone