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Attacking the HPA axis from the other direction.

Posted by SLS on October 1, 2005, at 13:00:49

Hi.

I am considering using dexamethasone to treat bipolar depression. Is anyone familiar with this treatment?


- Scott


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Acta Psychiatr Scand. 1997 Jan;95(1):58-61. Related Articles, Links


Dexamethasone augmentation in treatment-resistant depression.

Dinan TG, Lavelle E, Cooney J, Burnett F, Scott L, Dash A, Thakore J, Berti C.

Department of Psychological Medicine, St Bartholomew's Hospital, London, UK.

A total of 10 patients who fulfilled DSM-III-R criteria for major depression were recruited to the study, each of whom had failed to respond to a 6-week course of treatment with either sertraline or fluoxetine. Each subject had baseline serum cortisol measurements together with a Hamilton depression (HAMD) score. All patients were started on dexamethasone (3 mg daily) for 4 days, while remaining on their antidepressant treatment. Further Hamilton ratings were made on days 5 and 21. Six patients showed a significant improvement, whilst two showed a minimal response. A good clinical response was associated with a high baseline cortisol level.

PMID: 9051162 [PubMed - indexed for MEDLINE]


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Am J Psychiatry. 1995 Feb;152(2):265-7. Related Articles, Links


Comment in:
Am J Psychiatry. 1996 Aug;153(8):1111-2; author reply 1112-3.
Am J Psychiatry. 1996 Aug;153(8):1112; author reply 1112-3.

Dexamethasone for the treatment of depression: a randomized, placebo-controlled, double-blind trial.

Arana GW, Santos AB, Laraia MT, McLeod-Bryant S, Beale MD, Rames LJ, Roberts JM, Dias JK, Molloy M.

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425-0742.

OBJECTIVE: The authors' goal was to assess dexamethasone for the treatment of depression. METHOD: Thirty-seven outpatients (11 men and 26 women) meeting DSM-III-R criteria for major depressive disorder were randomly assigned to receive either placebo or 4 mg/day of oral dexamethasone for 4 days. Baseline Hamilton depression scale scores were compared with scores obtained 14 days after the first dose of study medication. Data were analyzed by using two-sample t tests, chi-square methods, and Fisher's exact test. RESULTS: Seven (37%) of the 19 patients given dexamethasone but only one (6%) of the 18 patients given placebo responded positively. No adverse events or side effects were reported, and all patients who entered the study completed it. CONCLUSIONS: A brief course of oral dexamethasone (4 days) was significantly more effective than placebo within 14 days for the treatment of depression in a randomized, double-blind study of depressed outpatients.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 7840362 [PubMed - indexed for MEDLINE]

 

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