Linked Life Data

12842167

Source:http://linkedlifedata.com/resource/pubmed/id/12842167

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2003-7-4
pubmed:abstractText
Although lithium augmentation is the foremost and most well-documented treatment strategy for treatment resistant depression, knowledge of factors related to response remains scanty. Findings with the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test are associated with response to treatment with a tricyclic antidepressant. This study investigated the potential predictive value of the DEX/CRH test for lithium augmentation response in major depressive disorder. The DEX/CRH test was conducted prior to lithium augmentation in 30 patients with a major depressive episode who had not responded to an antidepressant monotherapy trial of at least 4 weeks. Response status was assessed weekly using the Hamilton Rating Scale for Depression. For multivariate prediction, a logistic regression analysis was performed. Eleven (37%) patients responded to lithium augmentation within 4 weeks. Responders showed higher ACTH response and lower cortisol response in the DEX/CRH test, but results were not statistically significant. However, non-responders had a statistically significant higher cortisol/ACTH peak ratio (3.43+/-1.75) compared to responders (2.18+/-1.38) (P=0.027). This ratio is an indicator for the sensitivity of the adrenal cortex to ACTH. A cortisol/ACTH peak ratio of 1.8 was identified as the best cutoff point to differentiate responders from non-responders. In conclusion, results suggest a more sensitive adrenal cortex in non-responders to lithium augmentation. The findings would be in line with the assumption of a more chronic course of depression with more pronounced biological alterations in the non-responder group, because chronic depression is known to cause enlargement of the adrenal gland with a subsequent hypersensitivity to ACTH. Results of this study should be confirmed in a larger study group.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0022-3956
pubmed:author
pubmed:issnType
Print
pubmed:volume
37
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
135-43
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:12842167-Adrenocorticotropic Hormone, pubmed-meshheading:12842167-Antidepressive Agents, pubmed-meshheading:12842167-Corticotropin-Releasing Hormone, pubmed-meshheading:12842167-Depressive Disorder, Major, pubmed-meshheading:12842167-Dexamethasone, pubmed-meshheading:12842167-Drug Therapy, Combination, pubmed-meshheading:12842167-Female, pubmed-meshheading:12842167-Humans, pubmed-meshheading:12842167-Hydrocortisone, pubmed-meshheading:12842167-Lithium, pubmed-meshheading:12842167-Logistic Models, pubmed-meshheading:12842167-Male, pubmed-meshheading:12842167-Middle Aged, pubmed-meshheading:12842167-Predictive Value of Tests, pubmed-meshheading:12842167-Psychiatric Status Rating Scales, pubmed-meshheading:12842167-Risk Factors, pubmed-meshheading:12842167-Treatment Outcome
pubmed:articleTitle
Association between response to lithium augmentation and the combined DEX/CRH test in major depressive disorder.
pubmed:affiliation
Department of Psychiatry, Technische Universität Dresden, Fetscherstrasse 74, D-01307, Dresden, Germany. bschor@mailbox.tu-dresden.de
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Research Support, Non-U.S. Gov't