Iizuka H, Kishimoto A, Nakamura J, Mizukawa R
Department of Neuro-Psychiatry, Faculty of Medicine, Tottori University, Yonago, Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 1996 Feb;16(1):33-6.
Clinical trial with a steroid suppressive agent, metyrapone, was carried out in 6 patients with treatment-resistant depression (3 patients with major depression and 3 with bipolar disorder). Up to 2,000 mg/day of metyrapone was administered for 4 weeks, and 10 trials of the therapy were done in these patients. Most patients completed the therapy without remarkable side effects. As a result, three patients (6 trials) showed remission within 4 weeks and one patient (one trial) showed a partial response. In the remitted patients, plasma cortisol levels were suppressed below 10 micrograms/dl during the therapy and plasma ACTH levels were elevated. These results indicate that "hypercortisolemia-induced depression" similar to Cushing's disease may be present in patients with treatment-resistant depression.
对6例难治性抑郁症患者（3例重度抑郁症患者和3例双相情感障碍患者）进行了使用类固醇抑制药物美替拉酮的临床试验。美替拉酮的给药剂量高达每日2000毫克，持续4周，对这些患者进行了10次该治疗试验。大多数患者完成了治疗，且无明显副作用。结果，3例患者（6次试验）在4周内显示缓解，1例患者（1次试验）显示部分反应。在缓解的患者中，治疗期间血浆皮质醇水平被抑制至低于10微克/分升，血浆促肾上腺皮质激素水平升高。这些结果表明，难治性抑郁症患者中可能存在类似于库欣病的“高皮质醇血症性抑郁症”。
