The Dexamethasone Suppression and Thyrotropin-Releasing Hormone Tests and Response to Treatment in Unipolar Depression

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Abstract
We examined retrospectively the response to tricyclic antidepressants and/or electroconvulsive therapy (ECT) in twenty-seven inpatients with major depressive disorder, primary unipolar subtype who had a thyrotropin-releasing hormone (TRH) test and dexamethasone suppression test (DST) prior to treatment. Thirteen failed to suppress on the DST and had a blunted thyroid stimulating hormone (TSH) response to TRH; nine had one test abnormality; and five had neither abnormality. Physicians selected ECT for patients with abnormalities on both tests significantly more frequently than for patients with one or neither test abnormalities. Fourteen of nineteen tricyclic trials and nine of ten courses of ECT resulted in unequivocally positive clinical response. There were no statistically significant relationships between tricyclic response and either test abnormality.

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