Tolerability of the dexamethasone-corticotropin releasing hormone test in major depressive disorder

J Psychiatr Res. 2011 Jan;45(1):24-8. doi: 10.1016/j.jpsychires.2010.04.020. Epub 2010 May 20.

Abstract

Background: The dexamethasone-corticotropin releasing hormone (Dex-CRH) test may differentially predict which depressed patients will respond to antidepressant medication. However, a comprehensive analysis of the safety of this test in psychiatric patients has not previously been performed.

Methods: We conducted a pooled analysis of depressed patients in four clinical studies. Observed and subjectively reported side-effects in 454 patients were collected for 90 minutes following CRH administration. Pre-test electrocardiograms were available in 250 patients to assess cardiac safety. Descriptive statistics were performed to evaluate these safety data.

Results: Eight-six (18.9%) subjects experienced no side-effects from the procedure. The mean number of side-effects per subject was 1.4±1.0. The most frequent adverse events were: flushing (n=216, 47.6%), feeling of warmth (144, 31.7%), hyperpnea/tachypnea (108, 23.8%), palpitations (37, 8.1%), and tachycardia (28, 6.2%). Side-effects were consistently mild and brief in duration. There were no serious adverse events.

Conclusion: The Dex-CRH test produces a mild, predictable side-effect profile, characterized by flushing, feelings of warmth, hyperpnea/tachypnea, palpitations, and tachycardia. These results provide reassurance that the Dex-CRH test is well tolerated in psychiatric patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Corticotropin-Releasing Hormone* / blood
  • Depressive Disorder, Major / blood
  • Depressive Disorder, Major / diagnosis*
  • Dexamethasone*
  • Electrocardiography / methods
  • Female
  • Glucocorticoids*
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Glucocorticoids
  • Dexamethasone
  • Corticotropin-Releasing Hormone