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The Predictive Value of the Dexamethasone Suppression Test

A Placebo-Controlled Study

Published online by Cambridge University Press:  02 January 2018

Eric D. Peselow ,
Michael Stanley ,
Ann-Marie Filippi ,
Faouzia Barouche ,
Paul Goodnick  and
Ronald R. Fieve
Eric D. Peselow*
Affiliation:
Department of Psychiatry, New York University School of Medicine
Michael Stanley
Affiliation:
Department of Psychiatry, Columbia College of Physicians and Surgeons, New York State Psychiatric Institute
Ann-Marie Filippi
Affiliation:
Foundation For Depression-Manic Depression, New York
Faouzia Barouche
Affiliation:
Department of Psychiatry, New York University School of Medicine
Paul Goodnick
Affiliation:
Foundation For Depression-Manic Depression, New York
Ronald R. Fieve
Affiliation:
Department of Psychiatry, Columbia College of Physicians and Surgeons, New York State Psychiatric Institute
*
∗1322 East 84th Street, Brooklyn, NY 11236, USA
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Abstract

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 HCI, a selective serotonin reuptake inhibitor, compared with that of imipramine HCI 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<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.

Type
Papers
Information
The British Journal of Psychiatry , Volume 155 , Issue 5 , November 1989 , pp. 667 - 672
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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