The predictive value of the dexamethasone suppression test. A placebo-controlled study.
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 HCl, a selective serotonin reuptake inhibitor, compared with that of imipramine HCl 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 less than 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.
Peselow
E D
ED
Department of Psychiatry, New York University School of Medicine, New York.
Stanley
M
M
Filippi
A M
AM
Barouche
F
F
Goodnick
P
P
Fieve
R R
RR
D000328:Adult; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003907:Dexamethasone; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007099:Imipramine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017374:Paroxetine; D010880:Piperidines / Q000627:therapeutic use*; D010919:Placebos; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales
D000928:Antidepressive Agents; D010880:Piperidines; D010919:Placebos; D017374:Paroxetine; D003907:Dexamethasone; D007099:Imipramine; D006854:Hydrocortisone