NORMAL PITUITARY-RESPONSE TO METYRAPONE IN THE MORNING IN DEPRESSED-PATIENTS - IMPLICATIONS FOR CIRCADIAN REGULATION OF CORTICOTROPIN-RELEASING HORMONE-SECRETION
Ea. Young et al., NORMAL PITUITARY-RESPONSE TO METYRAPONE IN THE MORNING IN DEPRESSED-PATIENTS - IMPLICATIONS FOR CIRCADIAN REGULATION OF CORTICOTROPIN-RELEASING HORMONE-SECRETION, Biological psychiatry, 41(12), 1997, pp. 1149-1155
Excess secretion of cortisol in depressed patients has been documented
by a number of investigators, which is presumed secondary to increase
d corticotropin (ACTH) and ACTH-releasing hormone (CRH) secretion. To
unmask the proposed increased central (CRH) drive, we administered met
yrapone in the AM to 13 depressed and 13 age- and sex-matched normal c
ontrol subjects, Metyrapone administration resulted in a prompt decrea
se in plasma cortisol and in an increase in 11-deoxycortisol, the inac
tive precursor, in all subjects, Both depressed patients and normal co
ntrol subjects demonstrated clear increases in ACTH and beta-lipotropi
n/ beta-endorphin production. There were no significant differences be
tween patients and controls in any hormonal measures following metyrap
one administration. These data suggest that: I) in the absence of nega
tive feedback (cortisol blockade), mildly to moderately depressed outp
atients do not manifest increased central drive in the morning; and 2)
the secretory capacity of the corticotropes do not differ between suc
h depressed patients and controls. (C) 1997 Society of Biological Psyc
hiatry.