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The hypothalamic stimulatory mechanism of action of metopirone, a drug used in the treatment of drug-induced and endogenous Cushing’s syndrome, has been investigated in 23 patients with Cushing’s disease and 17 normal subjects. During infusion of 400 mug metopirone, ACTH and cortisol responses were similar in both groups. During infusion of 100 mug metopirone, the CRH test also gave a similar response in normal subjects and patients with Cushing’s disease. Our results indicate that only a low dose of metopirone is sufficient to evoke an ACTH-cortisol response. Therefore, metopirone should be administered to patients with Cushing’s disease in a dosage of 100 mug.Comments on: The Business Case for Encouraging Babies to Breathe, by Bryan Paskett, MD
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