Prednisone augmentation in treatment-resistant depression with fatigue and hypocortisolaemia: A case series

Colin Bouwer, Johann Claassen, Timothy G. Dinan, Charles B. Nemeroff

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis have long been implicated in major depression with hypercortisolaemia reported in typical depression and hypocortisolaemia in some studies of atypical depression. We report on the use of prednisone in treatment-resistant depressed patients with reduced plasma cortisol concentrations. Six patients with treatment-resistant major depression were found to complain of severe fatigue, consistent with major depression, atypical subtype, and to demonstrate low plasma cortisol levels. Prednisone 7.5 mg daily was added to the antidepressant regime. Five of six patients demonstrated significant improvement in depression on prednisone augmentation of antidepressant therapy. Although hypercortisolaemia has been implicated in some patients with depression, our findings suggest that hypocortisolaemia may also play a role in some subtypes of this disorder. In treatment-resistant depressed patients with fatigue and hypocortisolaemia, prednisone augmentation may be useful. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)44-50
Number of pages7
JournalDepression and anxiety
Issue number1
StatePublished - 2000
Externally publishedYes


  • Depression
  • Ftigue
  • Hypocortisolaemia
  • Hypothalamic
  • Pitpituiry-adrena l axis
  • Prednisone

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)
  • Clinical Psychology


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