Treatment of major depression with steroid suppressive drugs
Abstract
The hypercorticism frequently observed in major depression, unaccompanied by signs of Cushing's syndrome, is still poorly understood. One suicidal young woman, with very high cortisol levels and unusual resistance to dexamethasone suppression, is described. She was successfully treated with steroid suppressive drugs (aminoglutethimide, metyrapone), had a prompt and complete remission and has remained well for more than two years on no medication. This success prompted an on-going clinical trial of this therapy. The available drugs and a working hypothesis of their action are discussed.
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In Cushing's disease, depressive symptoms can be relieved by surgical correction of the hypercortisolemia.
“In Cushing’s disease, there are depressive symptoms that can be relieved by surgical correction of the hypercortisolemia (Starkman and Schteingart, 1981; Murphy, 1991).”
From Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators (2008) · cites this paper as Murphy, 1991
Both major depression and Cushing's disease are associated with chronic elevation of cortisol that results in gradual loss of minerals from bone and abdominal obesity.
“Both major depression and Cushing's disease are associated with chronic elevation of Cortisol that results in gradual loss of minerals from bone and abdominal obesity.”
From Protective and damaging effects of stress mediators: central role of the brain (2006) · cites this paper as [110]
In Cushing's disease, depressive symptoms can be relieved by surgical correction of the hypercortisolemia.
“In Cushing's disease, there are depressive symptoms that can be relieved by surgical correction of the hypercortisolemia.110,111”
From Protective and damaging effects of stress mediators: central role of the brain (2006) · cites this paper as [110]
Cites
Steroid hormone metabolites are barbiturate-like modulators of the GABA receptor
Majewska, M. D., Harrison, N. L., Schwartz, R. D., Barker, J. L., & Paul, S. M. (1986) · Science · doi:10.1126/science.2422758 · Cited by 2,225 · see citing works
Luton, J.-P., Cerdas, S., Billaud, L., Thomas, G., Guilhaume, B., Bertagna, X., Laudat, M.-H., Louvel, A., Chapuis, Y., Blondeau, P., et al. (1990) · New England Journal of Medicine · doi:10.1056/nejm199004263221705 · Cited by 717 · see citing works
The use of ketoconazole as an inhibitor of steroid production
Oates, J. A., Wood, A. J. J., & Sonino, N. (1987) · New England Journal of Medicine · doi:10.1056/nejm198709243171307 · Cited by 395 · see citing works
CORRELATIONS BETWEEN THE CHEMICAL STRUCTURE AND THE PHARMACOLOGICAL ACTIONS OF THE STEROIDS1
Selye, H. (1942) · Endocrinology · doi:10.1210/endo-30-3-437 · Cited by 350 · see citing works
Successful Treatment of Cushing’s Syndrome with the Glucocorticoid Antagonist RU 486*
Nieman, L. K., Chrousos, G. P., Kellner, C. H., Spitz, I. M., NISULA, B. C., Cutler, G. B., Merriam, G. R., Bardin, C. W., & Loriaux, D. L. (1985) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-61-3-536 · Cited by 314 · see citing works
Murphy, B. E. P. (1991) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/0960-0760(91)90312-s · Cited by 244 · see citing works
Howlett, T. A., REES, L. H., & BESSER, G. M. (1985) · Clinics in Endocrinology and Metabolism · doi:10.1016/s0300-595x(85)80083-9 · Cited by 237 · see citing works
The New Steroid Analog RU 486 Inhibits Glucocorticoid Action in Man
BERTAGNA, X. Y., BERTAGNA, C., LUTON, J. P., Husson, J., & Girard, F. (1984) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-59-1-25 · Cited by 235 · see citing works
Ketoconazole and Other Imidazole Derivatives as Inhibitors of Steroidogenesis
Feldman, D. (1986) · Endocrine Reviews · doi:10.1210/edrv-7-4-409 · Cited by 216 · see citing works
Metyrapone in long-term management of Cushing's disease.
Jeffcoate, W. J., REES, L. H., Tomlin, S., Jones, A. E., Edwards, C., & BESSER, G. M. (1977) · BMJ · doi:10.1136/bmj.2.6081.215 · Cited by 164 · see citing works
Effects of Amino-glutethimide on Adrenal Function in Man1
Fishman, L. M., Liddle, G. W., Island, D. P., et al. (1967) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-27-4-481 · Cited by 156 · see citing works
Structure of a novel human granulocyte peptide with anti-ACTH activity
Singh, A., Bateman, A., Zhu, Q., et al. (1988) · Biochemical and Biophysical Research Communications · doi:10.1016/s0006-291x(88)81118-5 · Cited by 92 · see citing works
Holzbauer, M., Birmingham, M. K., Nicola, A. F. D., & Oliver, J. T. (1985) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(85)90147-5 · Cited by 90 · see citing works
Physiological aspects of steroids with anaesthetic properties.
HOLZBAUER, M. (1976) · PubMed · Cited by 78 · see citing works
Aminoglutethimide and ketoconazole: Historical perspectives and future prospects
Shaw, M., Nicholls, P. J., & Smith, H. J. (1988) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(88)90217-8 · Cited by 51 · see citing works
The Dexamethasone Suppression Test and Depression
Arana, G. W., & Mossman, D. (1988) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(18)30431-6 · Cited by 41 · see citing works
The Inhibition of Human Adrenal Steroidogenic Enzyme Activities by Suramin*
ASHBY, H., DiMattina, M., Linehan, W. M., et al. (1989) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-68-2-505 · Cited by 29 · see citing works
Effects of aminoglutethimide on plasma estrone sulfate not caused by aromatase inhibition
Lønning, P. E., Johannessen, D. C., Thorsen, T., & Ekse, D. (1989) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(89)90039-3 · Cited by 28 · see citing works
Lønning, P. E., & Skulstad, P. A. (1989) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(89)90042-3 · Cited by 26 · see citing works
Sayers, G., SEELIG, S. A., & Kumar, S. (1975) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(75)90159-4 · Cited by 13 · see citing works
Effect of aminoglutethimide on extraglandular metabolism of exogenous testosterone
Horký, K., Kuchel, O., Stárka, L., et al. (1971) · Metabolism · doi:10.1016/0026-0495(71)90118-1 · Cited by 12 · see citing works
Contrasting effects of 5α- and 5β-pregnane-3,20-dione on the motor activity of ovariectomized rats
Dhar, V., Stark, R., Kraulis, I., et al. (1987) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(87)90010-0 · Cited by 12 · see citing works
Aminoglutethimide (Elipten® CIBA)—A New Inhibitor of Steroid Biosynthesis
Horký, K., & KÜCHEL, O. (1969) · Annals of Internal Medicine · doi:10.7326/0003-4819-70-4-866 · Cited by 7 · see citing works
Endocrinology of neuropsychiatric disorders.
(1988) · PubMed · Cited by 7 · see citing works
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Holsboer, F. (2000) · Neuropsychopharmacology · doi:10.1016/s0893-133x(00)00159-7 · Cited by 2,181 · see citing works
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Jahn, H., Schick, M., Kiefer, F., Kellner, M., Yassouridis, A., & Wiedemann, K. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.12.1235 · Cited by 184 · see citing works
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- Authors
- Pearson Murphy, B. E.
- Venue
- The Journal of Steroid Biochemistry and Molecular Biology
- Publisher
- Elsevier BV
- Published
- 1991-08
- Volume
- 39
- Issue
- 2
- Pages
- 239-244
- ISSN
- 0960-0760 (ISSN-L)
- OpenAlex
- W2017523345
- Cited by
- 67
- References
- 24
- Citations by year
- 2020: 1 · 2017: 2 · 2016: 3 · 2013: 2 · 2012: 1
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Steroid Biochemistry and Molecular Biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- major depressive disorder, hypercortisolism, aminoglutethimide, metyrapone, cortisol, suicidal depression, remission, mechanism of action
- MeSH terms
- Adrenocortical Hyperfunction, Adult, Aged, Aminoglutethimide, Cushing Syndrome, Depressive Disorder, Female, Humans, Male, Metyrapone
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