What is the desired therapeutic effect of mitotane in a patient with Cushing's disease?

The desired therapeutic effect of mitotane in a patient with Cushing's disease is to achieve decreased cortisol levels. Mitotane acts as an adrenolytic agent, specifically targeting the adrenal cortex to reduce the production of cortisol. In Cushing's disease, there is typically an overproduction of cortisol due to an adrenal tumor or pituitary adenoma that stimulates the adrenal glands. By lowering cortisol levels, mitotane helps alleviate the symptoms associated with Cushing's disease, which can include weight gain, high blood pressure, mood changes, and other metabolic disorders.

This reduction in cortisol is crucial because high cortisol levels can lead to severe complications such as diabetes, hypertension, and increased risk of infections. Therefore, the primary goal of using mitotane is to bring cortisol levels to a normal range, thereby managing the clinical manifestations of Cushing's disease and improving the patient's overall health status.