Treatment responses in adult depressive patients treated with dexamethasone/corticotrophin-releasing hormone

Purpose: To study the dexamethasone/corticotrophin releasing hormones (DEX/CRH) in depressed and healthy patients and to analyse the occurrence of relapse connected to hormonal dysregulation. Methods: A total of 117 depressive patients between 20 and 70 years of age were included in the study group and 40 healthy patients between 25 and 60 years of age in the control group. Group I consisted of 59 patients who received sertraline 50 - 100 mg/day for 5 weeks along with a low dose of 30 mg T3. Group II included 58 patients who received dexamethasone 1 mg orally for 5 weeks. DEX/CRH levels were analyzed. Adrenocorticotrophic hormone and cortisol levels in the blood were analysed by immuno-radiometric assay. Cortisol levels were also analysed by kinetic assay method. Results: In group I, among the 59 patients that received sertraline 50-100 mg/day for 5 weeks with a low dose of 30 mg T3, relapse was observed in 12 (20.3 %) of them. The area under the curve (AUC) was 13.9 +/- 6.4 ng. min. 1000/mL, which was higher than that for healthy individuals (3.8 +/- 3.6 ng. min. 1000/mL). Group I patients with relapse showed an adrenocorticotrophic hormone AUC of 16.9 +/- 2.4 ng. min. 1000/mL, while group II patients exhibited AUC of 13.9 +/- 6.4 ng. min. 1000/mL. Conclusion: The results emphasizes the need to test hormonal responses to different types of antidepressants.