| Project/Area Number |
07671068
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Psychiatric science
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| Research Institution | Tottori University |
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Principal Investigator |
KISHIMOTO Akira Tottori Univ.Faculty of Medicine.Dept.of Neuropsychiatry. Assis.Prof., 医学部附属病院, 講師 (00093584)
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| Co-Investigator(Kenkyū-buntansha) |
INOUE Yuichi Tottori Univ.Faculty of Med.Dept.of Neuropsychiatry. Assis.Prof., 医学部, 講師 (50213179)
MATSUNAGA Shinjiro Tottori Univ.Faculty of Med.Dept.of Neuropsychiatry. Assistant, 医学部附属病院, 助手 (90271048)
NAKAMURA Junnichi Tottori Univ.Faculty of Med.Dept.of Neuropsychiatry. Assistant, 医学部附属病院, 助手 (90237404)
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| Project Period (FY) |
1995 – 1996
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| Project Status |
Completed (Fiscal Year 1996)
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| Budget Amount *help |
¥2,400,000 (Direct Cost: ¥2,400,000)
Fiscal Year 1996: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1995: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | treatment-resistant depression / cortisol / CRH / ACTH / metyrapone / hypercortisolemia / cortisol synthesis inhibitor / 抗うつ薬抵抗性 / HPA系 |
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| Research Abstract |
Currently, the presence of the patients resistant to ordinary treatment with some antidepressants is the most important problems clinically. These treatment-resistant cases shows "so-called" hypercortisolemia just like unmedicated patients. This study tried to reveal the clinical meaning of hypercortisolemia using drugs which suppress the synthesis of cortisol and to compare the response of adrenocorticotropic hormone (ACTH) and cortisol (COR) by the administration of corticotropin-releasing hormone (CRH) to antidepressant-resistant patients and/or others.
As results, metyrapone which suppress the cortisol synthesis produced the remmission in patients with bipolar disorders, but a slight improvement in patients with major depression. Some patients showed no improvement in spite of the disappearance of hypercortisolemia.
Comparing the responses of ACTH and COR after injection of 100 mug CRH in 68 patients with depression or healthy controls, ACTH and COR responses to CRH in treatment-resitant patients were significantly lower in comparison with non treatment-resistant or unmedicated patients.
From these results, it was considered that the hypercortsolemia is state-dependent phenomenon but not origin of depression, and the decreased response of ACTH or COR to CRH were considered to be caused from the long-term exposure to hypercoltisolemia or others and, moreover, the CRH test was thought a strong tool to distinguish treatment-resitant patients from pseudo-treatment-resistant patients under inadequate antidepressant treatment.
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