Abstract
We have developed a suppressive test for the hypothalamic-pituitary-adrenal (HPA)
axis using prednisolone, which is similar to endogenous glucocorticoids. We used a
single-blind, repeated-measure design in healthy volunteers. In the first phase of
the study, we compared placebo or prednisolone 2.5 mg, 5 mg, or 10 mg; in the second
phase of the study, we compared placebo or prednisolone 5 mg or dexamethasone .5 mg.
On the following day, we collected plasma and salivary cortisol levels from 9 am to 5 pm. Maximal average prednisolone plasma levels (at 9 am after the 10-mg dose) were 30 to 35 ng/mL. At all doses, prednisolone caused a larger
suppression of salivary cortisol (approximately 20% after 2.5 mg, 30% to 35% after
5 mg, and 70% to 75% after 10 mg) than of plasma cortisol (approximately 5% after
2.5 mg, 10% after 5 mg, and 35% after 10 mg). Dexamethasone .5 mg gave 80% suppression
of plasma cortisol and 90% suppression of salivary cortisol. Plasma and salivary cortisol
levels were more consistently correlated in each subject after prednisolone than after
dexamethasone. We propose that prednisolone at the 5-mg dosage (which gave partial
HPA suppression), together with the assessment of salivary cortisol, can be used to
investigate both impaired and enhanced glucocorticoid-mediated negative feedback in
large samples of patients with psychiatric disorders.
Keywords
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Article info
Publication history
Accepted:
October 3,
2001
Received in revised form:
September 24,
2001
Received:
March 12,
2001
Identification
Copyright
© 2002 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
