Increased activity of the hypothalamus-pituitary-adrenal system after treatment with the mineralocorticoid receptor antagonist spironolactone

Psychoneuroendocrinology. 2000 Jul;25(5):513-8. doi: 10.1016/s0306-4530(00)00006-8.

Abstract

The hippocampal mineralocorticoid receptor (MR) is critical for the regulation of the basal activity of the hypothalamus-pituitary-adrenocortical (HPA) system. It has been hypothesized that reduced capacity of the hippocampal MR is involved in the HPA-system dysregulation found in depression and aging. We applied the combined dexamethasone suppression/corticotropin releasing hormone stimulation (DEX/CRH) test to six healthy young females both before and after 12 days of treatment with the MR antagonist spironolactone to assess HPA regulation. Treatment with spironolactone caused a significant increase in post-dexamethasone cortisol concentrations (75.1+/-56.7 vs. 36.6+/-24.6 nmol/l, p<0.05). Furthermore, we observed a significant rise in peak cortisol concentration after additional human CRH (hCRH) application (223. 6+/-139.1 vs. 126.7+/-73.3 nmol/l, p<0.02). There was no change in ACTH plasma concentrations. We thus conclude that (1) the MR antagonist spironolactone affects HPA system regulation as reflected in the DEX/CRH test and (2) these findings are in accordance with the assumption that MR dysfunction may underlie HPA-system dysfunction in depression and/or aging.

Publication types

  • Clinical Trial

MeSH terms

  • Adrenal Glands / drug effects
  • Adrenal Glands / physiology*
  • Adrenocorticotropic Hormone / blood
  • Adult
  • Corticotropin-Releasing Hormone
  • Dexamethasone
  • Female
  • Glucocorticoids
  • Humans
  • Hydrocortisone / blood
  • Hypothalamus / drug effects
  • Hypothalamus / physiology*
  • Mineralocorticoid Receptor Antagonists*
  • Pituitary Gland / drug effects
  • Pituitary Gland / physiology*
  • Receptors, Mineralocorticoid / physiology*
  • Spironolactone*

Substances

  • Glucocorticoids
  • Mineralocorticoid Receptor Antagonists
  • Receptors, Mineralocorticoid
  • Spironolactone
  • Dexamethasone
  • Adrenocorticotropic Hormone
  • Corticotropin-Releasing Hormone
  • Hydrocortisone