Pharmacopsychiatry 2011; 21 - A76
DOI: 10.1055/s-0031-1292517

Gender related differential response to dexamethasone in endocrine and immune measures in depressed patients and healthy controls

A Menke 1, A Eichelkraut 1, L Preis 1, T Klengel 1, M Rex-Haffner 1, M Uhr 1, F Holsboer 1, EB Binder 1
  • 1Max Planck Institute of Psychiatry, Munich, Germany

Background: Although women have a higher prevalence of depression than men, the underlying pathophysiology of these sex differences is widely unknown. Reproductive steroids are potent modulators of the hypothalamic-pituitary-adrenal (HPA-) axis, which is often disturbed in depression. We used a dexamethasone (dex) suppression test as well as a dexamethasone/corticotropin-releasing hormone (dex/CRH) test to investigate gender differences in HPA-axis regulation in depressed patients and healthy controls. Methods: We enrolled 108 depressed patients and 123 healthy controls (39%/25% females). Blood was collected at 6 pm and 3 hours after ingestion of 1.5 mg dex for measurement of cortisol, ACTH and differential white blood count. The next day we performed the dex/CRH test in a subset of individuals (n = 160). Results: Compared to controls, cortisol suppression 3 h and 21 h after dex was reduced only in male patients (p < 0.05). Additionally, the cortisol response in the dex/CRH test was more elevated in male (p < 0.05) but not in female patients as compared to controls. In fact, female patients even showed a blunted response compared to female controls. In addition, only in males the white blood counts for granulocytes and monocytes were differentially regulated by dex between cases and controls (p < 0.05). Conclusion: The results indicate that there are substantial differences in the response to GR activation in female and male patients, affecting HPA axis regulation and the immune system.