Two small studies, the latest appearing last month in the journal Biological Psychiatry, have found that mifepristone is effective in helping people whose severe depression is accompanied by delusional beliefs or hallucinations. Of the 30 patients in the recent study, those who took mifepristone for seven days at dosages higher than those used for abortions showed substantial and rapid improvement in their symptoms, the researchers found. The drug produced only mild side effects in the study.
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Patients with psychotic depression often suffer from delusions, believing, for example, that they deserve punishment for imagined crimes or that they have terminal illnesses.
Psychiatrists have traditionally treated psychotically depressed patients with some combination of antidepressants, antipsychotic drugs and electroshock therapy, an approach that has yielded only moderate success.
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A chemical compound used for abortions may seem an odd candidate for a depression drug. But mifepristone attracted the attention of researchers for good reason.
Mifepristone induces abortion by blocking the action of progesterone, a hormone necessary for implanting a fertilized egg in the lining of the uterus.
But in higher doses, the drug also blocks another hormone, cortisol, which is secreted by the adrenal glands and plays a critical role in the body's response to stress. Patients with psychotic depression, studies have shown, often have elevated levels of cortisol.
