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  • Title: [Clinical effects of cortisol synthesis inhibition on treatment-resistant depression].
    Author: Iizuka H, Kishimoto A, Nakamura J, Mizukawa R.
    Journal: Nihon Shinkei Seishin Yakurigaku Zasshi; 1996 Feb; 16(1):33-6. PubMed ID: 8640461.
    Abstract:
    Clinical trial with a steroid suppressive agent, metyrapone, was carried out in 6 patients with treatment-resistant depression (3 patients with major depression and 3 with bipolar disorder). Up to 2,000 mg/day of metyrapone was administered for 4 weeks, and 10 trials of the therapy were done in these patients. Most patients completed the therapy without remarkable side effects. As a result, three patients (6 trials) showed remission within 4 weeks and one patient (one trial) showed a partial response. In the remitted patients, plasma cortisol levels were suppressed below 10 micrograms/dl during the therapy and plasma ACTH levels were elevated. These results indicate that "hypercortisolemia-induced depression" similar to Cushing's disease may be present in patients with treatment-resistant depression.
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