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Morning Plasma Cortisol Levels Suppressed

Edward J. Sachar, MD; Gregory Asnis, MD; R. Swami Nathan, MD; Uriel Halbreich, MD; Mary Ann Tabrizi, RN; Frieda S. Halpern, MA

Arch Gen Psychiatry. 1980;37(7):755-757.

Abstract
• Dextroamphetamine sulfate administered intravenously in the morning to 11 unmedicated depressed patients suppressed previously elevated plasma cortisol levels to normal in 90 minutes, a fall of 33% from baseline. Ten other depressed patients, without amphetamine, maintained high cortisol levels during the same time period. In each of five normal young men, amphetamine identically administered stimulated a rise in cortisol between 15 and 30 minutes after infusion, an acute response absent in ten of the 11 depressed patients; by 90 minutes after amphetamine administration, plasma cortisol had fallen to normal and identical levels in both groups. Since noradrenalin normally inhibits hypothalamic corticotropin releasing factor (and adrenocorticotropic hormone) secretion, a noradrenergic deficit may account for cortisol hypersecretion in depression; amphetamine may transiently "correct" this deficit in depressed patients, thereby reducing their cortisol secretion.

Author Affiliations
From the New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York.

Footnotes
Accepted for publication Dec 11, 1979.

Reprint requests to Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 722 W 168th St, New York, NY 10032 (Dr Sachar).

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