Linked Life Data

19909979

Source:http://linkedlifedata.com/resource/pubmed/id/19909979

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2010-4-5
pubmed:abstractText
Preclinical and clinical studies have suggested a role of the mineralocorticoid receptor (MR) in the response to antidepressants. We tested in a proof-of-concept study whether adding fludrocortisone (an MR agonist) or spironolactone (an MR antagonist) accelerates onset of action and improves efficacy of escitalopram in patients with major depression. We included 64 in- and outpatients with major depression (Hamilton Depression Scale-17 score>18) in a double-blind, randomized, placebo-controlled trial. Patients were randomized in a 2:2:1 fashion to fludrocortisone (0.2 mg/d, n=24) or spironolactone (100 mg/d, n=27) or placebo (n=13) for the first 3 weeks during a 5-week treatment with escitalopram. No differences in mean HAMD change scores and in time to response emerged between treatments. However, among the responders, patients treated with fludrocortisone responded faster (Breslow test, p=0.05). The mean number of days to response was 16.0+/-2.6 days vs. placebo 22.2+/-2.0 vs. spironolactone 22.6+/-2.3 (F=3.78, p=0.03). In the whole group, plasma cortisol increased during spironolactone and decreased during fludrocortisone treatment (F=2.4, p=0.04). In patients treated with fludrocortisone, non-responders had elevated cortisol values compared to responders throughout the study period (F=5.1, p=0.04). Stimulation of MR with fludrocortisone as adjunct to escitalopram accelerated the response in the group of responders while no effect emerged in the sample as a whole. A larger randomized controlled trial is warranted.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
1879-1379
pubmed:author
pubmed:copyrightInfo
Copyright 2009 Elsevier Ltd. All rights reserved.
pubmed:issnType
Electronic
pubmed:volume
44
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
339-46
pubmed:meshHeading
pubmed-meshheading:19909979-Adult, pubmed-meshheading:19909979-Aged, pubmed-meshheading:19909979-Aldosterone Antagonists, pubmed-meshheading:19909979-Antidepressive Agents, Second-Generation, pubmed-meshheading:19909979-Citalopram, pubmed-meshheading:19909979-Depressive Disorder, Major, pubmed-meshheading:19909979-Diagnostic and Statistical Manual of Mental Disorders, pubmed-meshheading:19909979-Double-Blind Method, pubmed-meshheading:19909979-Drug Therapy, Combination, pubmed-meshheading:19909979-Female, pubmed-meshheading:19909979-Fludrocortisone, pubmed-meshheading:19909979-Humans, pubmed-meshheading:19909979-Hydrocortisone, pubmed-meshheading:19909979-Inpatients, pubmed-meshheading:19909979-Male, pubmed-meshheading:19909979-Middle Aged, pubmed-meshheading:19909979-Outpatients, pubmed-meshheading:19909979-Receptors, Mineralocorticoid, pubmed-meshheading:19909979-Spironolactone, pubmed-meshheading:19909979-Time Factors, pubmed-meshheading:19909979-Treatment Outcome, pubmed-meshheading:19909979-Young Adult
pubmed:year
2010
pubmed:articleTitle
Modulation of the mineralocorticoid receptor as add-on treatment in depression: a randomized, double-blind, placebo-controlled proof-of-concept study.
pubmed:affiliation
Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Germany. otte@uke.uni-hamburg.de
pubmed:publicationType
Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't