{'fraction_non_alphanumeric': 0.03961084086170952, 'fraction_numerical': 0.020152883947185545, 'mean_word_length': 5.486486486486487, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
A preliminary study of dexamethasone treatment on pituitary–adrenal responsivity in major depression

Major depression is characterized by overactivity of the hypothalamic–pituitary–adrenal (HPA) axis. Dexamethasone (DEX), the glucocorticoid agonist, has been shown to be effective in the treatment of depression. We chose to examine the impact of a short course of DEX treatment on depressive symptomatology, and on the pituitary‐adrenal response to CRH administration. In this preliminary study, five subjects with major depression were treated for 4 days with 3 mg DEX; a CRH test was performed before and after treatment. Four subjects showed a reduction in ACTH (p=0·01) and cortisol output (p<0·01) following DEX treatment. All subjects showed a drop in depression scores after treatment; the Hamilton Depression score fell by 11·4±1·7 (mean±SEM) from baseline (p=0·01) and the Beck Depression score by 9·2±2·5 (mean±SEM) from baseline (p=0·01); this represented a reduction by almost 50 per cent from baseline levels on both depression indices. We suggest that the impact of DEX treatment on depressive symptoms may reflect a restraining influence on an overactive HPA, with a normalization of pituitary–adrenal response to CRH drive. Larger studies are required to investigate this further and to ascertain whether the mood and neuroendocrine changes induced by dexamethasone are sustained. Copyright © 1999 John Wiley & Sons, Ltd.