TY - JOUR
T1 - A novel prednisolone suppression test for the hypothalamic-pituitary-adrenal axis.
AU - Pariante, C M
AU - Papadopoulos, A S
AU - Poon, L
AU - Checkley, S A
AU - English, J
AU - Kerwin, R W
AU - Lightman, S
PY - 2002/6/1
Y1 - 2002/6/1
N2 - We have developed a suppressive test for the hypothalamic-pituitary-adrenal (HPA) axis using prednisolone, which is similar to endogenous glucocorticoids. We used a single-blind, repeated-measure design in healthy volunteers. In the first phase of the study, we compared placebo or prednisolone 2.5 mg, 5 mg, or 10 mg; in the second phase of the study, we compared placebo or prednisolone 5 mg or dexamethasone .5 mg. On the following day, we collected plasma and salivary cortisol levels from 9 AM to 5 Pm. Maximal average prednisolone plasma levels (at 9 Am after the 10-mg dose) were 30 to 35 ng/mL. At all doses, prednisolone caused a larger suppression of salivary cortisol (approximately, 20% after 2.5 mg, 30% to 35% after 5 mg, and 70% to 75% after 10 mg) than of plasma cortisol (approximately 5% after 2.5 mg, 10% after 5 mg, and 35% after 10 mg). Dexamethasone .5 mg gave 80% suppression of plasma cortisol and 90% suppression of salivary cortisol. Plasma and salivary cortisol levels were more consistently correlated in each subject after prednisolone than after dexamethasone. We propose that prednisolone at the 5-mg dosage (which gave partial HPA suppression), together with the assessment of salivary cortisol, can be used to investigate both impaired and enhanced glucocorticoid-mediated negative feedback in large samples of patients with psychiatric disorders. Biol Psychiatry 2002;51:922-930 (C) 2002 Society of Biological Psychiatry.
AB - We have developed a suppressive test for the hypothalamic-pituitary-adrenal (HPA) axis using prednisolone, which is similar to endogenous glucocorticoids. We used a single-blind, repeated-measure design in healthy volunteers. In the first phase of the study, we compared placebo or prednisolone 2.5 mg, 5 mg, or 10 mg; in the second phase of the study, we compared placebo or prednisolone 5 mg or dexamethasone .5 mg. On the following day, we collected plasma and salivary cortisol levels from 9 AM to 5 Pm. Maximal average prednisolone plasma levels (at 9 Am after the 10-mg dose) were 30 to 35 ng/mL. At all doses, prednisolone caused a larger suppression of salivary cortisol (approximately, 20% after 2.5 mg, 30% to 35% after 5 mg, and 70% to 75% after 10 mg) than of plasma cortisol (approximately 5% after 2.5 mg, 10% after 5 mg, and 35% after 10 mg). Dexamethasone .5 mg gave 80% suppression of plasma cortisol and 90% suppression of salivary cortisol. Plasma and salivary cortisol levels were more consistently correlated in each subject after prednisolone than after dexamethasone. We propose that prednisolone at the 5-mg dosage (which gave partial HPA suppression), together with the assessment of salivary cortisol, can be used to investigate both impaired and enhanced glucocorticoid-mediated negative feedback in large samples of patients with psychiatric disorders. Biol Psychiatry 2002;51:922-930 (C) 2002 Society of Biological Psychiatry.
U2 - 10.1016/S0006-3223(01)01314-2
DO - 10.1016/S0006-3223(01)01314-2
M3 - Article
SN - 1873-2402
VL - 51
SP - 922
EP - 930
JO - Biological psychiatry
JF - Biological psychiatry
IS - 11
ER -