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Re: Mifepristone and CRF Antagonists Trials in UK info David Glover

Posted by SLS on January 24, 2005, at 17:06:32

In reply to Re: Mifepristone and CRF Antagonists Trials in UK info, posted by David Glover on January 19, 2005, at 18:12:11

Mifepristone (RU-486) blocks cortisol receptors in addition to progesterone receptors. The thought is that perhaps a brief blockade of cortisol receptors will cause the HPA axis (hypothalamus-pituitary-adrenal) to reset itself. Many people with unipolar depression (usually melancholic, agitated, or psychotic) and bipolar depression have elevated secretion of cortisol and a blunted suppressor response to dexamethasone.

The most common current treatment protocol being used to investigate mifepristone is to administer it for 7 days. Hopefully, the patient begins to improve and remains improved after the drug is discontinued. The dosage that I've seen used is 600mg per day.

Mifepristone is claimed to be able to reduce the psychotic symptoms of psychotic depression, but not the depression itself. It can also help with cognitive impairment. The NIMH is currently studying it in bipolar depression. I'm hoping that they have good reason to believe it is effective. I will probably try it.

Mifepristone is only available in the amounts necessary to treat depression (and other things like Cushings) through a compassionate use program. One must apply to the FDA for a special individual IND that is granted to your doctor. I have no idea how long it takes to get the drug this way. However, mifepristone has been placed on a "fast-track" by the FDA for the indication of psychotic depression and has been in phase III for this indication.

After speaking to a few researchers about it, I am not terribly enthused that mifepristone is showing itself to be more selective for the psychotic an cognitive symptoms than the depression itself.


- Scott

 

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