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The Journal of Clinical Endocrinology & Metabolism Vol. 84, No. 6 2238-2240
Copyright © 1999 by The Endocrine Society

Original Studies

Desmopressin Normalizes the Blunted Adrenocorticotropin Response to Corticotropin-Releasing Hormone in Melancholic Depression: Evidence of Enhanced Vasopressinergic Responsivity

Timothy G. Dinan, Ena Lavelle, Lucinda V. Scott, John Newell-Price, Sami Medbak and Ashley B. Grossman

Departments of Psychological Medicine (T.G.D., E.L., L.V.S.) and Endocrinology (J.N.-P., S.M., A.B.G.), St. Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, United Kingdom

Address all correspondence and requests for reprints to: Prof. Ted Dinan, Department of Psychiatry, Royal College of Surgeons in Ireland, St. Stephen’s Green, Dublin 2, Ireland. E-mail: tdinan{at}indigo

Major depression is associated with significant disturbance in hypothalamic-pituitary-adrenal axis functioning, including blunted release of ACTH in response to CRH infusion. Eight melancholic depressives and eight matched healthy comparison subjects underwent, in random order, the following challenges: placebo, CRH, CRH+DDAVP. Blood for ACTH and cortisol estimation was drawn at -15, 0, 15, 30, 45, 60, 90, and 120 min. A blunted release of ACTH, in response to CRH challenge, was observed in depression (P < 0.01), whereas maximal cortisol responses in both groups were similar, despite elevated baseline levels in depression (P < 0.05). The combined CRH/DDAVP infusion produced similar ACTH and cortisol release in both groups. These results suggest that melancholic depression is associated with enhanced pituitary vasopressinergic responsivity.




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Copyright © 1999 by The Endocrine Society