Murphy B E, Filipini D, Ghadirian A M
Department of Medicine, McGill University, Montreal, Quebec.
J Psychiatry Neurosci. 1993 Nov;18(5):209-13.
The rationale for the use of anti-glucocorticoids in the treatment of major depression has been reviewed. Four patients with chronic severe depression who were resistant to conventional therapies were given RU 486 (200 mg/day) for periods up to eight weeks. Substantial levels of RU 486 were achieved within the first few days, and the levels fell gradually over the week after the treatment was discontinued. In three cases, treatment was stopped before the eight weeks were completed: in one case because of the appearance of a rash, in the others because of side-effects, which, in retrospect, were likely unrelated to the drug. The mean scores on the Hamilton Rating Scale for Depression of three patients decreased. Levels of adrenocorticotrophin, dehydroepiandrosterone and cortisol rose during treatment. These preliminary results suggest that glucocorticoid antagonists may be effective in the treatment of major depression and merit further exploration.
抗糖皮质激素用于治疗重度抑郁症的理论依据已得到综述。4例对传统疗法耐药的慢性重度抑郁症患者接受了RU 486（200毫克/天）治疗，疗程长达8周。在最初几天内就达到了较高的RU 486水平，停药后一周内该水平逐渐下降。3例患者在8周疗程结束前停止治疗：1例是因为出现皮疹，其他几例是因为出现副作用，回顾起来，这些副作用可能与药物无关。3例患者的汉密尔顿抑郁量表平均得分有所下降。治疗期间促肾上腺皮质激素、脱氢表雄酮和皮质醇水平升高。这些初步结果表明，糖皮质激素拮抗剂可能对治疗重度抑郁症有效，值得进一步探索。
