0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Effect of Ketoconazole on a Hypophysectomized, Hypercortisolemic, Psychotically Depressed Woman

C. Lewis Ravaris, MD, PhD; Michael J. Sateia, MD; Kenneth W. Beroza, MD; Douglas L. Noordsy, MD; Truls Brinck-Johnsen, PhD
Arch Gen Psychiatry. 1988;45(10):966-967. doi:10.1001/archpsyc.1988.01800340094019.
Text Size: A A A
Published online

To the Editor.—  Depressed patients often but not invariably demonstrate a significant elevation in plasma cortisol concentration and a greatly augmented secretion of cortisol in the urine.1,2 The extent to which hypercortisolemia is a primary or secondary manifestation of the psychopathology is under investigation.3We had the unique opportunity to study a relationship between the level of plasma and urinary cortisol and the severity of the mood disorder in a depressed, 38-year-old woman who had undergone hypophysectomy. We administered ketoconazole, a broadspectrum antifungal agent that is a potent, rapidly acting, reversible inhibitor of cortisol-synthesizing 11-β-hydroxylase, a P-450-dependent enzyme. We did this during a recent hospitalization of the patient and noted a prompt reduction in cortisol production, with an equally prompt improvement in the patient's depressive illness. We present briefly the salient features of her diagnostic evaluation and inpatient treatment.

Report of a Case.—  The patient reported a long-standing

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();