Objective: The authors tested the hypothesis that patients with major depre
ssion have a defect in the mechanism by which cortisol exerts negative feed
back on the hypothalamic-pituitary-adrenal (HPA) axis during the HPA axis q
uiescent period.
Method: Twenty-nine patients with major depression and 25 healthy compariso
n subjects were randomly assigned to administration of 15 mg cortisol or pl
acebo infused over 2 hours beginning at 7:00 p.m. Cortisol and ACTH levels
were measured at baseline and every 30 minutes from 7:30 p.m. to 11:00 p.m.
Results: Differences between the patients and the comparison subjects in th
e ACTH response to the cortisol infusion, relative to the ACTH response to
placebo, were not found.
Conclusions: The results provide some evidence that patients with major dep
ression do not have an abnormality of cortisol feedback during the HPA axis
quiescent period.