Desmopressin normalizes the blunted adrenocorticotropin response to corticotropin-releasing hormone in melancholic depression: Evidence of enhanced vasopressinergic responsivity

Major depression is associated with significant disturbance in hypothalamic -pituitary-adrenal axis functioning, including blunted release of ACTH in r esponse to CRH infusion. Eight melancholic depressives and eight matched he althy comparison subjects underwent, in random order, the following challen ges: placebo, CRH, CRH + DDAVP. Blood for ACTH and cortisol estimation was drawn at -15, 0, 15, 30, 45, 60, 90, and 120 min. A blunted release of ACTH , in response to CRH challenge, was observed in depression (P < 0.01), wher eas maximal cortisol responses in both groups were similar, despite elevate d baseline levels in depression (P < 0.05). The combined CRH/DDAVP infusion produced similar ACTH and cortisol release in both groups. These results s uggest that melancholic depression is associated with enhanced pituitary va sopressinergic responsivity.