The metyrapone test in affective disorders and schizophrenia II: Changes upon treatment

The metyrapone test was applied to groups of patients suffering from major depressive illness with melancholia, mania or schizophrenia, before and after treatment. There were interesting individual correlations between post-metyrapone cortexolone values, cortexolone/cortisol ratios and clinical improvement in depressives. Two patients who had exhibited abnormal metyrapone responses displayed a normalization of post-metyrapone cortexolone values upon clinical improvement, whereas the opposite trend was observed in a patient who did not improve and in another who became manic. These preliminary results may indicate that abnormal metyrapone responses in depression are state dependent.