Rapid Reversal of Psychotic Depression Using Mifepristone

@article{Belanoff2001RapidRO,
  title={Rapid Reversal of Psychotic Depression Using Mifepristone},
  author={Joseph K. Belanoff and Benjamin H. Flores and Michelle Kalezhan and Brenda Sund and Alan F. Schatzberg},
  journal={Journal of Clinical Psychopharmacology},
  year={2001},
  volume={21},
  pages={516-521}
}
The rationale for treating psychotic major depression with glucocorticoid receptor (GR) antagonists is reviewed. Five patients with psychotic major depression were given 600 mg of mifepristone in a 4-day, double-blind, placebo-controlled crossover study. All the patients completed the protocol and adverse effects were not observed or reported. All of the five patients showed substantial improvements in their Hamilton Rating Scale for Depression scores while they were receiving mifepristone, and… 
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TLDR
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An open label trial of C-1073 (mifepristone) for psychotic major depression*
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TLDR
The replication of a statistically significant linear association between mifepristone plasma concentration and clinical response indicates that mifEPristone at sufficient plasma levels may potentially be effective in rapidly and durably reducing the psychotic symptoms of patients with psychotic depression.
Combined Analysis of Mifepristone for Psychotic Depression: Plasma Levels Associated With Clinical Response
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TLDR
It is proposed that the apparent efficacy of fluvoxamine in psychotic major depression may be related to its unique property of high affinity for the σ1receptor, which is thought to play a role in psychosis and in the action of some antipsychotic drugs.
Mifepristone (RU-486) treatment for depression and psychosis: a review of the therapeutic implications
TLDR
The present review examines the current literature for the clinical utility of GR antagonists (specifically mifepristone) in mood disorders and psychosis and concludes that most studies are at the “proof-of-concept” stage, although the results of preliminary, randomized, controlled trials are encouraging.
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