POSSIBLE USE OF GLUCOCORTICOID RECEPTOR ANTAGONISTS IN THE TREATMENT OF MAJOR DEPRESSION - PRELIMINARY-RESULTS USING RU-486

The rationale for the use of antiglucocorticoids in the treatment of m ajor depression has been reviewed. Four patients with chronic severe d epression who were resistant to conventional therapies were given RU 4 86 (200 mg/day) for periods up to eight weeks. Substantial levels of R U 486 were achieved within the first few days, and the levels fell gra dually over the week after the treatment was discontinued. In three ca ses, treatment was stopped before the eight weeks were completed: in o ne case because of the appearance of a rash, in the others because of side-effects, which, in retrospect, were likely unrelated to the drug. The mean scores on the Hamilton Rating Scale for Depression of three patients decreased. Levels of adrenocorticotrophin, dehydroepiandroste rone and cortisol rose during treatment. These preliminary results sug gest that glucocorticoid antagonists may be effective in the treatment of major depression and merit further exploration.