Normal pituitary response to metyrapone in the morning in depressed patients: implications for circadian regulation of corticotropin-releasing hormone secretion

Biological Psychiatry
E A YoungHuda Akil

Abstract

Excess secretion of cortisol in depressed patients has been documented by a number of investigators, which is presumed secondary to increased corticotropin (ACTH) and ACTH-releasing hormone (CRH) secretion. To unmask the proposed increased central (CRH) drive, we administered metyrapone in the AM to 13 depressed and 13 age- and sex-matched normal control subjects. Metyrapone administration resulted in a prompt decrease in plasma cortisol and in an increase in 11-deoxycortisol, the inactive precursor, in all subjects. Both depressed patients and normal control subjects demonstrated clear increases in ACTH and beta-lipotropin/beta-endorphin production. There were no significant differences between patients and controls in any hormonal measures following metyrapone administration. These data suggest that: 1) in the absence of negative feedback (cortisol blockade), mildly to moderately depressed outpatients do not manifest increased central drive in the morning; and 2) the secretory capacity of the corticotropes do not differ between such depressed patients and controls.

References

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Citations

Jun 29, 2004·Psychoneuroendocrinology·Elizabeth A YoungJon-Kar Zubieta
Mar 5, 2003·Hormones and Behavior·Karen J ParkerDavid M Lyons
Jul 15, 1998·Neuroscience and Biobehavioral Reviews·A J Mitchell
Sep 21, 2010·Neurobiology of Learning and Memory·Linn K KuehlHartmut Schachinger
Dec 17, 2008·Hormones and Behavior·Sonja RoemerHartmut Schächinger
Dec 4, 2004·Biological Psychiatry·Michael KellnerBarbara Alm
Feb 7, 2006·Biological Psychiatry·Jennifer KellerAlan F Schatzberg
Jul 19, 2005·Journal of the American College of Cardiology·Andrew J M BroadleyMichael P Frenneaux
Jul 4, 2006·Journal of the American College of Cardiology·Andrew J M BroadleyMichael P Frenneaux
Sep 24, 2010·The International Journal of Neuropsychopharmacology·Charlotte KeatingJayashri Kulkarni
Dec 14, 2011·The Journal of Reproduction and Development·Hai Thanh DuongDariusz Jan Skarzynski

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