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Titolo:
Ketoconazole in bipolar patients with depressive symptoms: a case series and literature review
Autore:
Brown, ES; Bobadilla, L; Rush, AJ;
Indirizzi:
Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75390 USA Univ Texas Dallas TX USA 75390 d Ctr, Dept Psychiat, Dallas, TX 75390 USA
Titolo Testata:
BIPOLAR DISORDERS
fascicolo: 1, volume: 3, anno: 2001,
pagine: 23 - 29
SICI:
1398-5647(200102)3:1<23:KIBPWD>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEXAMETHASONE SUPPRESSION TEST; CUSHINGS-SYNDROME; ATYPICAL DEPRESSION; MAJOR DEPRESSION; ANTIGLUCOCORTICOID TREATMENT; LABORATORY TEST; CORTISOL; THERAPY; MANIFESTATIONS; PSYCHIATRY;
Keywords:
bipolar disorder; cortisol; depression; ketoconazole; mania; mixed stale;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Brown, ES Univ Texas, SW Med Ctr, Dept Psychiat, 5323 Harry Hines Blvd, Dallas, TX 75390 USA Univ Texas 5323 Harry Hines Blvd Dallas TX USA 75390 X 75390 USA
Citazione:
E.S. Brown et al., "Ketoconazole in bipolar patients with depressive symptoms: a case series and literature review", BIPOL DIS, 3(1), 2001, pp. 23-29

Abstract

Background: Data from several studies suggest that medications, such as ketoconazole, which lower cortisol levels, may be effective for major depressive disorder (MDD). As with MDD, the manic, depressive, and mixed phases ofbipolar disorder are frequently associated with elevated cortisol levels. The literature on the use of cortisol-lowering strategies in mood disordersis reviewed, and a case series illustrating the use of ketoconazole in bipolar depression is presented. Methods: For the review, the MEDLINE and PSYCHINFO databases were searched, as were the bibliographies of pertinent articles to find papers on the use of cortisol-lowering agents in patients with mood disorders. In our open-label case series (n = 6), ketoconazole (up to 800 mg/day) as an add-on therapy was given to patients with treatment-resistant or intolerant bipolar Ior II disorders with current symptoms of depression. Results: Several case reports and small open studies suggest that cortisol-lowering agents may be useful for patients with depression. Two recent placebo-controlled trials of ketoconazole on patients with MDD report conflicting results. In our case series, all three patients who received a dose of at least 400 mg/day had substantial reductions in depressive symptoms. Nonehad significant increases in mania. However, cortisol levels were not lowered in any of the subjects. Conclusions: The literature suggests that cortisol-lowering medications may he effective for a subset of depressed patients. Our preliminary findingssuggest that ketoconazole may be useful in some patients with bipolar depression. Larger clinical trials are needed to confirm our observations.

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Documento generato il 27/01/20 alle ore 14:08:28