Dexamethasone for the treatment of depression: a preliminary report.
BACKGROUND
This preliminary uncontrolled trial of intravenous dexamethasone addresses the question of the utility of a glucocorticoid for the treatment of depression.


METHODS
Patients with a DSM-III-R (SCID confirmed) diagnosis of major depression or bipolar disorder, depressed type, and a Hamilton Rating Scale for Depression (HAM-D) score of greater than or equal to 20 were selected. Baseline HAM-D scores were compared with scores within 10 days after intravenous infusion of dexamethasone; data were analyzed by t tests. Control subjects (no psychiatric illness and HAM-D scores less than 5) were given intravenous dexamethasone to test for its mood-altering effect.


RESULTS
The mean HAM-D scores in 16 depressed subjects 10 days after intravenous dexamethasone dropped by 56% (p less than .0001), and 75% of the patients experienced a greater than 50% reduction in HAM-D scores. Additionally, 6 nonpsychiatric, nondepressed control subjects were given intravenous dexamethasone and found to have no changes in mental status examination.


CONCLUSIONS
Intravenous dexamethasone may be an effective treatment for depressive illnesses. Because this was an uncontrolled, unblinded trial, further studies need to be done in nonpsychiatric and psychiatric controls to ascertain the validity of this finding.
Arana
G W
GW
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425-0742.
Forbes
R A
RA
D000328:Adult; D000339:Affect / Q000187:drug effects; D000368:Aged; D000553:Ambulatory Care; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D003907:Dexamethasone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
D003907:Dexamethasone