Clonidine Challenge of Cortisol Secretion in Dementia and Geriatric Depression

Abstract

The effect of oral clonidine challenge on cortisol secretion was evaluated in seven patients with primary degenerative dementia and in seven patients with major depression. Postclonidine cortisol levels were decreased in all depressed patients and in demented patients with hypercortisolemia at baseline. Demented patients with normal cortisol levels at baseline developed increased post-clonidine cortisol levels. These preliminary findings suggest differences in noradrenergic regulation of cortisol secretion among patients with primary degenerative dementia.

Cognitive and Noncognitive Symptoms in Dementia Patients: Relationship to Cortisol and Dehydroepiandrosterone

“…Although a number of abnormalities have been reported in HPA axis activity in Alzheimer's disease (AD), e.g., decreased adrenocorticotropic hormone (ACTH) levels in cerebrospinal fluid (CSF) (Nappi et al, 1988;Suemaru et al, 1991), elevated urinary free cortisol (Maeda et al, 1991), elevated corticotropin-releasing factor (CRF) in CSF (Martignoni et al, 1990a(Martignoni et al, , 1990b, elevated rates of nonsuppression of cortisol in response to the dexamethasone suppression test (DST) (Bilikiewicz & Bidzan, 1990;Davous et al, 1988;Ferrier et al, 1988;Gierl et al, 1987;Gurevich et al, , 1990Hatzinger et al, 1995;Leake et al, 1990;Maeda et al, 1991;Masugi et al, 1989;Molchan et al, 1990;Oxenkrug et al, 1989;Parnetti et al, 1990;Serby et al, 1988;Siegel et al, 1989;Skare et al, 1990;Vollhardt et al, 1989), and elevated baseline cortisol levels (Masugi et al, 1989;O'Brien et al, 1996;Tollefson et al, 1989), others have failed to replicate these findings. Roelandts (1989) found no difference in ACTH estimations in the CSF of 17 patients with dementia.…”