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Twenty patients, diagnosed as suffering from treatment-resistant major depression,
were treated with one or more drugs that decrease corticosteroid biosynthesis. Nine
were psychotic, 11 nonpsychotic. Seventeen completed the treatment (8 psychotic, 9
nonpsychotic); 13 responded (5 psychotic, 8 nonpsychotic; 11 responded completely
(i.e., a drop in the Hamilton Depression Scale of at least 50%, to ≤ 15), and 2 responded
partially. The mean age of the responders (45.2 ± 12.6 years) did not differ significantly
from that of the nonresponders (48.7 ± 12/3). Data were analyzed in the following
categories; (1) the presence or absence of psychosis, (2) response or nonresponse
to treatment, and (3) the drug(s) used (aminoglutethimide, ketoconazole, or a combination
of either of these with metyrapone). The patients improved over time on the Hamilton
Depression Scale independent of the medication used. Responders demonstrated improvement
in mood, insomnia, anxiety, diurnal variation, paranoia and obsessive compulsiveness.
Nonpsychotics responded better than psychotics.
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Article info
Publication history
Received in revised form:
May 13,
1994
Received:
December 17,
1993
Footnotes
This work was supported by the Fonds de la Recherche en santé du Québec and by the Fraser award of the Royal Victoria Hospital.
Identification
Copyright
© 1995 Society of Biological Psychiatry. Published by Elsevier Inc.
