A short course of mifepristone - better known as the abortion drug RU486 - leads to significant improvement in patients with major depressive episodes with psychotic features, according to new study findings.

In many cases, because of the extreme danger of harming themselves, people with psychotic depression have to be hospitalized and undergo Electroconvulsive therapy (ECT), also known as electroshock therapy.

Previous studies have indicated that mifepristone may have rapid antidepressant effects in these circumstances, Dr. George M. Simpson of the University of Southern California, Los Angeles, and colleagues note, but results were clouded by patients taking other drugs simultaneously.

To clarify the situation, the researchers studied 20 subjects with psychotic depression who were taking no psychotropic medications. They were given a 6-day course of mifepristone, and followed as hospitalized patients for a total of 8 weeks.

Significant improvements in standardized depression scores were seen after 1 week and up to 4 weeks, but not thereafter, according to the report in the Journal of Clinical Psychiatry.

The researchers note that the study had limitations, but nevertheless conclude that the findings “hold promise for a more rapid, relatively safe treatment for psychotic depression.”

If the results are confirmed in controlled trials, Simpson told that mifepristone “would represent a totally new approach to treating the most severe depression - psychotic depression. It would also suggest studies in severe non-psychotic depression.”

SOURCE: Journal of Clinical Psychiatry, May 2005.