Rapid reversal of psychotic depression using mifepristone

J Clin Psychopharmacol. 2001 Oct;21(5):516-21. doi: 10.1097/00004714-200110000-00009.


The rationale for treating psychotic major depression with glucocorticoid receptor (GR) antagonists is reviewed. Five patients with psychotic major depression were given 600 mg of mifepristone in a 4-day, double-blind, placebo-controlled crossover study. All the patients completed the protocol and adverse effects were not observed or reported. All of the five patients showed substantial improvements in their Hamilton Rating Scale for Depression scores while they were receiving mifepristone, and four of the five patients showed substantial improvement in their Brief Psychiatric Rating Scale scores. Little, if any, improvement was seen with placebo. These preliminary results suggest that short-term use of GR antagonists may be effective in the treatment of psychotic major depression and that additional study, perhaps using higher doses or more treatment days, seems warranted.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adrenocorticotropic Hormone / blood
  • Adult
  • Aged
  • Brief Psychiatric Rating Scale
  • Cross-Over Studies
  • Depressive Disorder, Major / blood
  • Depressive Disorder, Major / drug therapy*
  • Double-Blind Method
  • Female
  • Hormone Antagonists / therapeutic use*
  • Humans
  • Hydrocortisone / blood
  • Male
  • Middle Aged
  • Mifepristone / therapeutic use*
  • Psychotic Disorders / blood
  • Psychotic Disorders / drug therapy*
  • Time Factors


  • Hormone Antagonists
  • Mifepristone
  • Adrenocorticotropic Hormone
  • Hydrocortisone