Siever L J, Uhde T W, Jimerson D C, Post R M, Lake C R, Murphy D L
Arch Gen Psychiatry. 1984 Jan;41(1):63-8. doi: 10.1001/archpsyc.1984.01790120067009.
Plasma cortisol responses to the intravenous administration of clonidine hydrochloride and placebo were evaluated in depressed patients and controls. Depressed patients had higher mean baseline cortisol levels than controls. Cortisol levels decreased during the morning study period following both placebo and 2 micrograms/kg of clonidine hydrochloride in the depressed patients, but the cortisol decrease was sixfold greater on the day of clonidine administration; these placebo-clonidine differences were statistically significant, whether calculated on an absolute decrement basis or as a percent change. In contrast, controls responded to clonidine with only a 1.5-fold greater cortisol reduction than that found after placebo, a nonsignificant difference from the day of placebo administration. Reductions in the concentration of plasma 3-methoxy-4-hydroxyphenylglycol following clonidine administration were significantly negatively correlated with baseline plasma cortisol levels, raising the possibility that abnormalities in the responsiveness of the alpha 2-noradrenergic system may be associated with the hypothalamo-pituitary-adrenal (HPA) axis dysfunction found in depressed patients.
在抑郁症患者和对照组中评估了血浆皮质醇对静脉注射盐酸可乐定和安慰剂的反应。抑郁症患者的平均基线皮质醇水平高于对照组。在抑郁症患者中，无论是服用安慰剂还是2微克/千克盐酸可乐定后，早晨研究期间皮质醇水平均下降，但在服用可乐定当天皮质醇下降幅度大六倍；这些安慰剂与可乐定之间的差异在统计学上具有显著性，无论是以绝对减量计算还是以百分比变化计算。相比之下，对照组对可乐定的反应仅为皮质醇降低幅度比服用安慰剂后大1.5倍，与服用安慰剂当天相比差异无统计学意义。服用可乐定后血浆3-甲氧基-4-羟基苯乙二醇浓度的降低与基线血浆皮质醇水平显著负相关，这增加了α2-去甲肾上腺素能系统反应性异常可能与抑郁症患者下丘脑-垂体-肾上腺（HPA）轴功能障碍有关的可能性。
