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Paradoxical cortisol responses to dextroamphetamine in endogenous depression
Archives of General Psychiatry
|October 1, 1981
Summary
Dextroamphetamine administration revealed abnormal cortisol responses in depressed patients, showing paradoxical suppression instead of the expected increase seen in normal subjects. This difference was most pronounced in the evening, suggesting potential diagnostic value for endogenous depression.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Pharmacology
Background:
- Endogenous depression is associated with neuroendocrine abnormalities.
- Cortisol dysregulation is a hallmark of depression.
- Dextroamphetamine is known to affect the hypothalamic-pituitary-adrenal (HPA) axis.
Purpose of the Study:
- To investigate the cortisol response to intravenous dextroamphetamine hydrochloride in patients with severe endogenous depression.
- To compare these responses with those of normal control subjects.
- To explore the potential diagnostic utility of the dextroamphetamine cortisol test in endogenous depression.
Main Methods:
- Intravenous administration of dextroamphetamine hydrochloride in the morning and evening.
- Measurement of plasma cortisol levels at specific time points post-administration.
- Comparison of cortisol responses between 22 unmedicated depressed patients and 18 normal controls.
Main Results:
- Normal subjects exhibited a sharp increase in plasma cortisol levels post-dextroamphetamine.
- Two-thirds of depressed patients showed paradoxical cortisol suppression by 60 minutes.
- The discrimination between groups was greatest in the evening.
Conclusions:
- Depressed patients demonstrate abnormal cortisol responses to dextroamphetamine, differing significantly from normal subjects.
- Potential defects in noradrenergic alpha-receptor activation may underlie these abnormal HPA axis responses.
- Further research is needed to establish the diagnostic utility of the dextroamphetamine cortisol test for endogenous depression.