title: L-5-hydroxytryptophan stimulated cortisol escape from dexamethasone suppression in melancholic patients.
abstract: The dexamethasone suppression test (DST) was carried out in 62 depressed patients. At 0800 the postdexamethasone cortisol values were determined and 125 mg L-5-hydroxytryptophan (L-5-HTP) was administered. The second cortisol sample at 0930 revealed a significant enhancing effect for L-5-HTP on the postdexamethasone cortisol values in melancholic patients, whereas no effects were detected in minor depressives. Our results show that L-5-HTP converts some DST suppressors into nonsuppressors, whereas the escape from dexamethasone in some nonsuppressors is markedly stimulated. The L-5-HTP-stimulated 0930 postdexamethasone cortisol values performed markedly better than the 0800 DST results: at a cut-off value of greater than or equal to 5 micrograms/dl the sensitivity for melancholia increased from 46% to 68%, and the specificity remained unchanged (96%).
authors.affiliation: Department of Psychiatry, University Hospital of Antwerp, Edegem, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Maes
authors.forename: P
authors.initials: P
authors.lastname: D'Hondt
authors.forename: M
authors.initials: M
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Claes
authors.forename: C
authors.initials: C
authors.lastname: Schotte
authors.forename: M
authors.initials: M
authors.lastname: Vandewoude
authors.forename: P
authors.initials: P
authors.lastname: Blockx
mesh_terms: D006916:5-Hydroxytryptophan / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis*; D003907:Dexamethasone; D005260:Female; D006760:Hospitalization; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012680:Sensitivity and Specificity; D012701:Serotonin / Q000502:physiology; D013491:Suppressor Factors, Immunologic / Q000187:drug effects
chemical_list: D010919:Placebos; D013491:Suppressor Factors, Immunologic; D012701:Serotonin; D003907:Dexamethasone; D006916:5-Hydroxytryptophan; D006854:Hydrocortisone