Dual-release hydrocortisone boosts cognition, sleep

Use of dual-release hydrocortisone (DR-HC) in the treatment of patients with adrenal insufficiency appears to confer extended benefits, such as that for cognitive function and quality of sleep, a study has found.

Adrenal insufficiency is usually treated with conventional hydrocortisone replacement therapy, which fails to imitate the circadian rhythm of cortisol secretion. DR-HC, on the other hand, resembles the daily normal cortisol profile and thereby improves metabolic parameters and quality of life.

In the present study, researchers evaluated the effect of DR-HC on cognitive function and well-being in 20 adult patients with adrenal insufficiency. These patients underwent 10 neuropsychological tests and completed well-established questionnaires to obtain demographic data and assess quality of life, symptoms of depression, and quality of sleep.

Comparisons were made by diagnosis (primary [PAI] vs secondary [SAI]) and dose (<20 vs ≥20 mg). Moreover, 18 DR-HC–treated patients were matched to an identical number of conventionally treated adults.

With respect to diagnosis, patients with PAI demonstrated significantly better results for intellectual abilities (p=0.038) and executive functioning (p=0.026). They also seemed to take a much longer time to fall asleep (p=0.026) than patients with SAI.

In terms of DR-HC dosage, there were no significant differences seen in any measures of cognitive function. Patients on high dose had a better subjective quality of sleep (p=0.028) than those on low dose.

Finally, compared with conventional HC treatment, DR-HC was more likely to yield more favourable results for executive functioning (p=0.099).