Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-31T14:24:33.012Z Has data issue: false hasContentIssue false
  • English
  • Français

The Predictive Value of the Dexamethasone Suppression Test

A Placebo-Controlled Study

Published online by Cambridge University Press:  02 January 2018

Eric D. Peselow ,
Michael Stanley ,
Ann-Marie Filippi ,
Faouzia Barouche ,
Paul Goodnick  and
Ronald R. Fieve
Eric D. Peselow*
Affiliation:
Department of Psychiatry, New York University School of Medicine
Michael Stanley
Affiliation:
Department of Psychiatry, Columbia College of Physicians and Surgeons, New York State Psychiatric Institute
Ann-Marie Filippi
Affiliation:
Foundation For Depression-Manic Depression, New York
Faouzia Barouche
Affiliation:
Department of Psychiatry, New York University School of Medicine
Paul Goodnick
Affiliation:
Foundation For Depression-Manic Depression, New York
Ronald R. Fieve
Affiliation:
Department of Psychiatry, Columbia College of Physicians and Surgeons, New York State Psychiatric Institute
*
∗1322 East 84th Street, Brooklyn, NY 11236, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

We evaluated the dexamethasone suppression test (DST) as a predictor of response to drugs and placebo in 105 patients, in a large double-blind placebo-controlled out-patient trial to determine the efficacy of paroxetine HCI, a selective serotonin reuptake inhibitor, compared with that of imipramine HCI and placebo. The presence of a positive or negative DST did not predict response to either paroxetine or imipramine. However, a positive DST predicted a poorer response to placebo: only 3 out of 18 patients who showed DST non-suppression responded to placebo, as opposed to 11 out of 21 who exhibited DST suppression (P<0.05). A positive DST was associated with a 61% response to drugs and a 16% response to placebo. This finding suggests that the presence of a positive DST implies the need for active somatic treatment.

Type
Papers
Information
The British Journal of Psychiatry , Volume 155 , Issue 5 , November 1989 , pp. 667 - 672
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ames, D., Burrows, G., Davies, B., et al (1984) A study of the dexamethasone suppression test in hospitalized depressed patients. British Journal of Psychiatry, 144, 311–313.Google Scholar
Amsterdam, J. D., Winokur, A., Bryant, S., et al (1983) The dexamethasone suppression test as a predictor of antidepressant response. Psychopharmacology, 80, 43–45.Google Scholar
APA Task Force on Laboratory Tests in Psychiatry (1987) The dexamethasone suppression test: an overview of its current status in psychiatry. American Journal of Psychiatry, 144, 1253–1262.Google Scholar
Arana, G. W., Baldessarini, R. J. & Ornsteen, M. (1985) The dexamethasone suppression test for diagnosis and prognosis in psychiatry. Archives of General Psychiatry, 42, 1193–1204.Google Scholar
Arana, G. W. & Baldessarini, R. J. (1987) Clinical use of the dexamethasone suppression test in psychiatry. In Psychopharmacology - The Third Generation of Progress (ed. H. Y. Meltzer). New York: Raven Press.Google Scholar
Baldessarini, R. J. & Arana, G. W. (1985) Does the dexamethasone suppression test have clinical utility in psychiatry? Journal of Clinical Psychiatry, 46, 25–29.Google Scholar
Beck, A. T. & Beamsderfer, A. (1974) Assessment of depression: the depression inventory. In Psychological Measurements in Psychopharmacology (ed. P. Pichot). Basel: Karger.Google Scholar
Beckmann, H., Holzmuller, B. & Fleckenstein, P. (1984) Dexamethasone suppression test predicts response to nomifensine or amitriptyline. British Journal of Psychiatry, 144, 440–441.Google Scholar
Borop, C., Meidahl, B., Petersen, I. M., et al (1982) An early clinical phase II evaluation of paroxetine, a new potent and selective 5HT-uptake inhibitor in patients with depressive illness. Pharmacopsychiatry, 15, 183–186.Google Scholar
Braddock, L. (1986) The dexamethasone suppression test - fact or artefact? British Journal of Psychiatry, 148, 363–374.Google Scholar
Brown, W. A., Johnston, R. & Mayfield, D. (1979) The 24 hour dexamethasone suppression test in a clinical setting - relationship to diagnosis, symptoms and response to treatment. American Journal of Psychiatry, 136, 543–547.Google Scholar
Brown, W. A., & Shuey, I. (1980) Response to dexamethasone and subtype of depression. Archives of General Psychiatry, 37, 747–751.Google Scholar
Brown, W. A., & Qualls, C. B. (1981) Pituitary-adrenal disinhibition in depression: marker of a subtype with characteristic clinical features and response to treatment? Psychiatry Research, 4, 115–128.Google Scholar
Brown, W. A., Shrivastava, R. K. & Arato, M. (1985) DST and intolerance to serotonin uptake inhibition. Scientific Proceedings of the 138th American Psychiatric Association Meeting, Dallas, New Research Abstract No. 95.Google Scholar
Brown, W. A., Shrivastava, R. K. & Arato, M. (1987) Pre-treatment pituitary–adrenocortical status and placebo response in depression. Psychopharmacology Bulletin, 23, 155–159.Google Scholar
Carroll, B. J. (1985) Dexamethasone suppression test: a review of contemporary confusion. Journal of Clinical Psychiatry, 46, 13–24.Google Scholar
Carroll, B. J., Feinberg, M., Greden, J. F., et al (1981) A specific laboratory test for the diagnosis of melancholia. Archives of General Psychiatry, 38, 15–22.Google Scholar
Coryell, W. (1982) Hypothalamic–pituitary–adrenal axis abnormality and ECT response. Psychiatry Research, 6, 283–292.Google Scholar
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview - the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry, 35, 837–844.Google Scholar
Georgatas, A., Stokes, P., McCue, R. E., et al (1986) The usefulness of the DST in predicting response to antidepressants: a placebo-controlled study. Journal of Affective Disorders, 11, 21–28.Google Scholar
Greden, J. F., Kronfol, Z., Gardner, R., et al (1981) Dexamethasone suppression test and selection of antidepressant medications. Journal of Affective Disorders, 3, 389–396.Google Scholar
Green, H. S. & Kane, J. M. (1983) The dexamethasone suppression test in depression. Clinical Neuropharmacology, 6, 7–24.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual For Psychopharmacology. Rockville, Maryland: National Institute of Mental Health, Psychopharmacology Research Branch.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. Journal of Clinical Psychology, 6, 278–296.Google Scholar
Janicak, P. G., Pandey, G. N., Sharma, R., et al (1987) Pre-treatment dexamethasone suppression test as a predictor of response to phenelzine. Journal of Clinical Psychiatry, 48, 480–482.Google Scholar
Kahn, A., Johnson, F., Avery, D. H., et al (1988) DST results in non-psychotic depressed outpatients. American Journal of Psychiatry, 145, 1153–1156.Google Scholar
Kovacs, M., Rush, A. J., Beck, A. T., et al (1981) Depressed outpatients treated with cognitive therapy or pharmacotherapy. Archives of General Psychiatry, 38, 33–39.Google Scholar
Lund-Laursen, A., Mikkelsen, P. L., Rasmussen, S., et al (1985) Paroxetine in the treatment of depression - a randomized comparison with amitriptyline. Acta Psychiatrica Scandinavica, 71, 249–255.Google Scholar
McLeod, W. R. (1972) Poor response to antidepressants and dexamethasone non-suppression. In Depressive Illness - Some Research Studies (eds B. Davies, B. J. Carroll & R. M. Mowbray). Springfield, Illinois: Charles C. Thomas Press.Google Scholar
McLeod, W. R., Carroll, B. J. & Davies, B. (1970) Hypothalamic dysfunction and antidepressant drugs. British Medical Journal, i, 480–481.Google Scholar
Montgomery, S. A. & Asberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 282–289.Google Scholar
Nelson, W. H., Orr, W. W., Stevenson, J. M., et al (1982) Hypothalamic–pituitary–adrenal axis activity and tricyclic response in major depression. Archives of General Psychiatry, 39, 1033–1036.Google Scholar
Peselow, E. D., Goldring, N., Barouche, F., et al (1985) The dexamethasone suppression test (DST) in predicting response to tricyclic antidepressants in depressed outpatients. Psychopathology, 18, 206–211.Google Scholar
Peselow, E. D., Goldring, N., Stanley, M., et al (1986a) The dexamethasone suppression test in predicting response to desipramine and amitriptyline in depressed outpatients. International Clinical Psychopharmacology, 1, 17–23.Google Scholar
Peselow, E. D., Lautin, A., Wolkin, A., et al (1986b) The dexamethasone suppression test and response to placebo. Journal of Clinical Psychopharmacology, 6, 286–291.Google Scholar
Peselow, E. D., Stanley, M., Wolkin, A., et al (1988) Clinical features, DST, and response to placebo in depressed outpatients. In New Directions in Affective Disorders (eds B. Lerer & S. Gershon). New York: Springer-Verlag.Google Scholar
Rush, A. J. (1984) A phase II study of cognitive therapy of depression. In Psychotherapy Research (eds J. B. W. Williams & R. L. Spitzer). New York: Guilford Press.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationality and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Weissman, M. M., Klerman, G. L., Prusoff, B. A., et al (1981) Depressed outpatients - results one year after treatment with drugs and/or interpersonal psychotherapy. Archives of General Psychiatry, 38, 51–55.Google Scholar
Young, R. C., Manley, M. W., Alexopoulos, G. S., et al (1982) Dexamethasone suppression test and nortriptyline response in the elderly. Scientific Proceedings of the 135th American Psychiatric Association Meeting, Toronto, New Research Abstract No. 38.Google Scholar
Zammit, G. K., Rosenbaum, A. H., Stokes, P., et al (1988) Biological differences in endogenous depressive placebo responders versus non-responders: dexamethasone suppression test and sleep EEG data. Biological Psychiatry, 24, 97–101.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.