Metyrapone is used for the medical control of hypercortisolism in Cushing's syndrome (ACTH dependent or independent). The aim for medical treatment is to achieve pre-operative control of hypercortisolism, or for control of residual disease persisting post-operatively (TSS, adrenalectomy). It is not for long term definitive treatment/cure, only as an adjunct (surgery is the aim for cure in most causes of Cushing's syndrome). Metyrapone hence acts by inhibiting adrenal steroidogenesis. One side effect is hirsutism (in women) because of the excess androgen precursors created. The other commonly used agent for medical treatment of Cushing's is ketoconazole (an anti-fungal agent). This does not exhibit the side effect of hirsutism.
Standardized rhodiola supplements have also been put to the test in physicians during two-week stretches on night duty and in students during final exams. These trials have confirmed the herb’s general anti-fatigue effect, showing that it improves tests of physical fitness, mental fatigue and neuromotor function under stress.
Many people who have tried rhodiolareport that they feel better while taking it. The experience is described in terms of a continuous sensation of physical and mental relief from stress, and anecdotally the effect appears to be most pronounced in people who typically respond to stress with anger or feelings of helplessness. Animal studies on rhodiola have given us some clues as to the neurochemical basis of these effects, such as its effects on the metabolism of the serotoninergic system, boosting brain levels of dopamine, acetylcholine, and norepinephrine. The evidence also seems to suggest that rhodiola influences the synthesis, levels, and/or activity of endorphins and enkephalins, since blocking the receptors for some of these “feel-good” peptides negates some of its effects.