The oCRH stimulation test before and after clinical recovery from depression

J Affect Disord. 1988 May-Jun;14(3):213-22. doi: 10.1016/0165-0327(88)90037-7.

Abstract

A substantial body of data suggests that excessive cortisol secretion in depression may result from a dysregulation at several sites within the hypothalamic-pituitary-adrenocortical (HPA) axis. These alterations in regulatory mechanisms are thought to be the result of a hypothalamic 'overdrive' of corticotropin-releasing hormone (CRH). Previous studies have demonstrated a diminished adrenocorticotropin (ACTH) secretory response, as well as a heightened adrenocortical responsiveness after ovine-CRH administration in depressed patients. In the present investigation, we examined pituitary and adrenocortical responsiveness after an ovine-CRH stimulation test before and during clinical recovery in seven depressed patients. Cumulative ACTH responses increased significantly during clinical recovery (P = 0.014). Paradoxically, maximum and peak cortisol responses increased after recovery, suggesting that heightened adrenocortical responsiveness to ACTH during depression may take longer to 'normalize' than abnormal pituitary responsiveness to ovine-CRH stimulation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adrenocorticotropic Hormone / blood*
  • Adult
  • Antidepressive Agents / therapeutic use*
  • Corticotropin-Releasing Hormone*
  • Depressive Disorder / blood
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Dexamethasone
  • Female
  • Humans
  • Hydrocortisone / blood*
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales

Substances

  • Antidepressive Agents
  • Dexamethasone
  • Adrenocorticotropic Hormone
  • Corticotropin-Releasing Hormone
  • Hydrocortisone