A Randomized Trial to Examine the Effect of Mifepristone on Neuropsychological Performance and Mood in Patients with Bipolar Depression
Biological Psychiatry, 07/10/2012
Watson S et al. – Brief treatment with mifepristone is associated with a sustained improvement in SWM, an effect that might be mediated by a persistent enhancement in hippocampal mineralocorticoid receptor function.Methods
- The authors examined the longer–term efficacy of 600 mg/day of mifepristone as an adjunctive treatment, for 1 week, in a placebo–controlled, randomized, double–blind trial in 60 patients with bipolar depression, with SWM as the primary outcome measure.
- A comparator group of healthy control subjects was also recruited.
- At baseline, neuropsychological performance of patients was impaired, but hypothalamic–pituitary–adrenal axis function did not differ from that of control subjects.
- Mifepristone treatment was associated with a time–limited increase in cortisol awakening response and with a sustained improvement in SWM performance, which was evident 7 weeks after the cessation of treatment.
- The magnitude of this neuropsychological response was predicted by the magnitude of the cortisol response to mifepristone.
- The response occurred in the absence of a significant improvement in depressed mood.