Cortisol feedback during the HPA quiescent period in patients with major depression

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.