An open label trial of C-1073 (mifepristone) for psychotic major depression

• Published in: Biological psychiatry (1969) Vol. 52; no. 5; pp. 386 - 392
• Main Authors: Belanoff, Joseph K, Rothschild, Anthony J, Cassidy, Frederick, DeBattista, Charles, Baulieu, Etienne-Emile, Schold, Clifford, Schatzberg, Alan F
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2002; Elsevier Science
• Subjects: Adult; Aged; Biological and medical sciences; C-1073 Mifepristone; cortisol; Depressive Disorder, Major - drug therapy; Dose-Response Relationship, Drug; Female; Hormone Antagonists - administration & dosage; Hormone Antagonists - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Mifepristone - administration & dosage; Mifepristone - therapeutic use; Neuropharmacology; Pharmacology. Drug treatments; Psychiatric Status Rating Scales; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; psychotic major depression; Treatment Outcome; cortisol; C-1073 Mifepristone; psychotic major depression; Mood disorder; Short term; Human; Neuroleptic; Psychotropic; Toxicity; Treatment efficiency; Psychotic depression; Depression; Antihormone; Dose activity relation; Psychosis; Symptomatology; Chemotherapy; Treatment; Follow up study; Antiprogesterone; Glucocorticoid receptor; Antidepressant agent; Mifepristone; Antagonist
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/S0006-3223(02)01432-4

The rationale for treating patients with psychotic major depression (PMD) with glucocorticosteroid receptor (GR) antagonists is explained. Thirty patients with PMD, with Hamilton Rating Scale for Depression (HAMD-21) scores of 18 or greater, were assigned in an open label trial to receive 50 mg, 600 mg, or 1200 mg of mifepristone for 7 days. All the subjects completed the protocol; there were no dropouts. Side effects were mild and sporadic. Of 19 subjects in the combined 600- and 1200-mg group, 13 had a 30% or greater decline in their Brief Psychiatric Rating Scale (BPRS) scores, compared with 4 of 11 in the 50-mg group. In the 600- and 1200-mg group, 12 of 19 subjects showed a 50% decline in the BPRS positive symptom subscale, a more sensitive index for the symptoms seen in PMD, compared with 3 of 11 in the 50-mg group; 8 of 19 subjects in the 600- and 1200-mg group had a 50% decline in the HAMD-21, compared with 2 of 11 in the 50-mg group. These results suggest that short term use of GR antagonists may be effective in the treatment of psychotic major depression and that further blinded studies are warranted.