Cited by 147Stress Responses and CortisolAdrenal Hormones and DisordersHormonal Regulation and Hypertension

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Different responses to dexamethasone and prednisolone in the same depressed patients

Juruena, Mario F., Cleare, Anthony J., Papadopoulos, Andrew S., Poon, Lucia, Lightman, Stafford, Pariante, Carmine M.·2006·Psychopharmacology

DOI 10.1007/s00213-006-0555-4

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Abstract

Rationale Patients with major depression show hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, but the mechanisms underlying this abnormality are still unclear.Objectives We have compared two synthetic glucorticoids, dexamethasone and prednisolone, in their ability to suppress the hypothalamic-pituitary-adrenal (HPA) axis in depressed patients. Dexamethasone probes glucocorticoid receptor (GR) function, while prednisolone probes both GR and mineralocorticoid receptor (MR) function.Materials and methods We used a single-blind, repeated-measure design. We administered placebo, prednisolone (5 mg) or dexamethasone (0.5 mg), at 22:00, to 18 severe, treatment-resistant depressed inpatients (15 of them with a history of childhood trauma) and 14 healthy volunteers. On the following days, we collected salivary cortisol from 9:00 to 22:00.Results Depressed patients had higher salivary cortisol levels compared with controls, at baseline and after both prednisolone and dexamethasone (p<0.001). Consistent with previous studies, depressed inpatients showed impaired suppression by dexamethasone: based on the analysis of the areas under the curve (AUCs), suppression by dexamethasone (0.5 mg) was -85% in controls vs -46% in depressed patients (p=0.018). However, the same depressed patients showed normal suppression by prednisolone (5 mg): suppression was -41% in controls and -36% in depressed patients (p=0.6).Conclusions We suggest that the additional effects of prednisolone on the MR explain the different responses to these glucocorticoids in the same depressed patients.

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Authors: Juruena, M. F., Cleare, A. J., Papadopoulos, A. S., Poon, L., Lightman, S., & Pariante, C. M.
Affiliations: King's College London (GB)
Bethlem Royal Hospital (GB)
University of Bristol (GB)
Corresponding author: Pariante, Carmine M.
ORCID: Cleare, Anthony J.
Lightman, Stafford
Pariante, Carmine M.
Venue: Psychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2006-10-03
Volume: 189
Issue: 2
Pages: 225-235
ISSN: 0033-3158 (ISSN-L)
1432-2072
DOI: 10.1007/s00213-006-0555-4
OpenAlex: W2080795205
Cited by: 147
References: 75
Citations by year: 2026: 2 · 2025: 2 · 2024: 9 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 9 · 2019: 8 · 2018: 4 · 2017: 12 · 2016: 3 · 2015: 10 · 2014: 8 · 2013: 11 · 2012: 7
FWCI: 2.87
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Psychopharmacology (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Bristol Research (University of Bristol) (submittedVersion)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords: major depressive disorder, dexamethasone suppression test, hypothalamic-pituitary-adrenal axis, HPA axis hyperactivity, glucocorticoid receptor, mineralocorticoid receptor, salivary cortisol, treatment-resistant depression, childhood trauma
MeSH terms: Major Depressive Disorder, Dexamethasone, Female, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Pituitary-Adrenal System, Prednisolone, Receptors, Glucocorticoid, Saliva, Salivary Glands, Single-Blind Method, Receptors, Mineralocorticoid, Area Under Curve

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Different responses to dexamethasone and prednisolone in the same depressed patients

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