CHANGES IN SERIAL DEXAMETHASONE SUPPRESSION TESTS AMONG UNIPOLAR DEPRESSIVES RECEIVING ELECTROCONVULSIVE TREATMENT

  • 1 January 1981
    • journal article
    • research article
    • Vol. 16  (6) , 551-560
Abstract
An abnormal dexamethasone suppression test (DST) identifies endogenous depressives with 95% confidence. The DST normalizes with successful treatment. Serial DST throughout treatment could provide useful information on whether they biologically monitor clinical response, when DST normalization does occur, and whether early normalization predicts clinical outcome. Six inpatients were studied who had abnormal DST on admission and serial DST during and after a course of ECT [electroconvulsive therapy]. All were diagnosed as unipolar major depressive disorder, endogenous (RDC). Clinical improvement was monitored with weekly Hamilton Rating Scales. Five of 6 abnormal DST patients converted to a normal test and showed significant clinical improvement. One patient failed to normalize and also had a poor outcome. All DST normalizations occurred by the 4th-6th ECT. Additional ECT resulted in further reduction in DST plasma cortisol values. All normalizers experienced progressive clinical improvement and the DST successfully monitored these changes. DST conversion occurred early in treatment. Early DST normalization may have predictive value for good treatment response.

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