Blunted ACTH response to dexamethasone suppression-CRH stimulation in posttraumatic stress disorder

• Published in: Journal of psychiatric research Vol. 42; no. 14; pp. 1185 - 1188
• Main Authors: Ströhle, Andreas, Scheel, Michael, Modell, Sieglinde, Holsboer, Florian
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.10.2008; Elsevier
• Subjects: ACTH; Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Case-Control Studies; Corticotropin releasing hormone; Corticotropin-Releasing Hormone - administration & dosage; Corticotropin-Releasing Hormone - blood; Corticotropin-Releasing Hormone - pharmacology; Cortisol; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - pharmacology; Dose-Response Relationship, Drug; Female; Glucocorticoids - administration & dosage; Glucocorticoids - pharmacology; Hormones; Humans; Hydrocortisone - blood; Hypothalamo-Hypophyseal System - drug effects; Hypothalamo-Hypophyseal System - physiopathology; Male; Medical sciences; Middle Aged; Multivariate Analysis; Negative feedback; Pituitary-Adrenal System - drug effects; Pituitary-Adrenal System - physiopathology; Post-traumatic stress disorder; Posttraumatic stress disorder; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radioimmunoassay; Stress Disorders, Post-Traumatic - blood; Stress Disorders, Post-Traumatic - physiopathology; Stress Disorders, Post-Traumatic - psychology; Corticotropin releasing hormone; ACTH; Posttraumatic stress disorder; Cortisol; Dexamethasone; Human; Corticosteroid; Hypothalamohypophysoadrenal axis; Steroid hormone; Anxiety disorder; Antiinflammatory agent; Corticotropin releasing factor; Neuroendocrine regulation; Experimental study; Hydrocortisone; Glucocorticoid; Stress; Dose activity relation; Hypothalamic hormone; Dexamethasone test; Adrenocorticotropic hormone; Adenohypophyseal hormone; Adrenal hormone; Hormone releasing factor
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2008.01.015

Previous studies have suggested that patients with posttraumatic stress disorder (PTSD) have an enhanced negative feedback sensitivity of the hypothalamic–pituitary–adrenal (HPA) system and a blunted ACTH response to corticotropin releasing hormone (CRH). The effects of two dexamethasone dosages (0.75 and 1.5 mg) on the ACTH and cortisol concentrations after CRH stimulation (100 μg) were studied in eight patients with PTSD and matched healthy control subjects. Compared to healthy subjects, patients with PTSD have a blunted ACTH response to CRH. Cortisol concentrations were only significantly influenced by dexamethasone dosage. Our results give further evidence for a central role of the pituitary in reflecting changes of the negative feedback sensitivity of the HPA system in patients with PTSD.