Research projects

Ongoing projects

Antiglucorticoid augementation of antiDepressants in Depression (The ADD study)

Abstract

Depression often responds poorly to treatment. There has been recent increased understanding of some of the causes of the frequent lack of complete response seen with antidepressants. The stress hormone, cortisol, is often elevated or poorly controlled in depression and there is laboratory and clinical research to show that this hormonal change reduces the benefits from antidepressants with associated poor outcome and memory problems. Preliminary studies show that reducing the effects of cortisol for between 1 and 3 weeks overcomes these negative consequences. We plan to study a drug that decreases cortisol levels in people who have not recovered with standard antidepressants so that we can find out the usefulness of this treatment (compared with placebo) in day to day life as well as checking closely for side-effects. We will also measure cortisol and see if its level can tell us which people do best with this treatment. We will carry out this study in 3 centres across the UK. We will carry out some additional tests of specific sorts of memory and decision making and also do this while scanning the brain as well as testing the sensitivity of the brain to hydrocortisone, a stress hormone. The study will help us find out if this drug should be used more widely for people not responding to standard treatments and will also lead on to the development of other new treatments with an anti-cortisol effect to help tackle the major problem of poor outcome from depression.

Duration of the project

May 2010 to July 2012

Funding body

Efficacy and Mechanism Evaluation Programme (NIHR)

Members of the project

Nicol FerrierPrincipal investigator
Professor Ian AndersonPrincipal investigator
Dr Peter HaddadPrincipal investigator
Cathy SymondsCollaborator
Profesor Rebecca ElliottCollaborator
Dr RH McAllister WilliamsCollaborator
Dr Stuart WatsonCollaborator
Professor AO HouseCollaborator
Professor EMM McCollCollaborator
Professor HCR GrunzeCollaborator
Dr TA HughesCollaborator
Dr J GrayCollaborator
Ms J WainwrightCollaborator
Ms FH WinterCollaborator

Aims

  • To investigate whether metyrapone is an effective treatment for depression in patients who have failed to respond to antidepressants
  • To investigate the hormonal and brain mechanisms involved in metyrapone's action