title: Tolerability of the dexamethasone-corticotropin releasing hormone test in major depressive disorder.
abstract: 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.
authors.affiliation: 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
authors.forename: Boadie W
authors.initials: BW
authors.lastname: Dunlop
authors.forename: Yara
authors.initials: Y
authors.lastname: Betancourt
authors.forename: Elisabeth B
authors.initials: EB
authors.lastname: Binder
authors.forename: Christine
authors.initials: C
authors.lastname: Heim
authors.forename: Florian
authors.initials: F
authors.lastname: Holsboer
authors.forename: Marcus
authors.initials: M
authors.lastname: Ising
authors.forename: Melissa
authors.initials: M
authors.lastname: McKenzie
authors.forename: Tanja
authors.initials: T
authors.lastname: Mletzko
authors.forename: Hildegard
authors.initials: H
authors.lastname: Pfister
authors.forename: Charles B
authors.initials: CB
authors.lastname: Nemeroff
authors.forename: W Edward
authors.initials: WE
authors.lastname: Craighead
authors.forename: Helen S
authors.initials: HS
authors.lastname: Mayberg
mesh_terms: 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
chemical_list: D000928:Antidepressive Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D003346:Corticotropin-Releasing Hormone