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Related Experiment Videos

Dexamethasone suppression test status does not predict differential response to nortriptyline versus amitriptyline.

A J Rush1, J Weissenburger, N Vasavada

  • 1Mental Health Clinical Research Center, University of Texas, Southwestern Medical Center, Dallas 75235.

Journal of Clinical Psychopharmacology
|December 1, 1988
PubMed
Summary

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The dexamethasone suppression test (DST) did not predict treatment response in major depression patients receiving amitriptyline or nortriptyline. Tricyclic antidepressant effectiveness was similar regardless of DST status.

Area of Science:

  • Psychiatry
  • Clinical Pharmacology
  • Neuroscience

Background:

  • Major depression is a prevalent mood disorder.
  • Tricyclic antidepressants (TCAs) like amitriptyline and nortriptyline are common treatments.
  • The dexamethasone suppression test (DST) has been investigated as a potential biomarker for depression and treatment response.

Purpose of the Study:

  • To investigate the predictive value of the 1.0-mg dexamethasone suppression test (DST) for treatment response in major depression.
  • To compare the efficacy of amitriptyline and nortriptyline in patients with nonpsychotic major depression.
  • To determine if DST status predicts differential response to amitriptyline versus nortriptyline.

Main Methods:

  • Thirty-five inpatients with nonpsychotic major depression were enrolled.

Related Experiment Videos

  • Patients underwent a placebo run-in period followed by double-blind randomization to amitriptyline or nortriptyline.
  • The 1.0-mg DST was administered before treatment initiation.

    • Main Results:

    • Thirty-two patients completed at least 3 weeks of active medication.
    • Twelve out of 32 patients (37.5%) were DST nonsuppressors.
    • Both amitriptyline and nortriptyline demonstrated equal effectiveness in treating major depression.
    • Pretreatment DST status did not predict overall treatment response or differential response between the two TCAs.

    Conclusions:

    • The 1.0-mg DST may have limited value in selecting between amitriptyline and nortriptyline for major depression treatment.
    • DST status does not appear to be a reliable predictor of TCA response in this patient population.
    • Further research is needed to clarify the role of DST in guiding antidepressant selection.