Repeated dexamethasone suppression test in major depression

A review is made on the repeated dexamethasone suppression test (DST) in patients with a major depression. In those patients treated with conventional antidepressants the gradual normalization of the DST results is significantly correlated with the evolution of the clinical picture as measured with the Hamilton Depression Rating Scale. Normalization of the DST precedes symptomatic improvement and can be used as a predictor of good clinical outcome. Persistent dexamethasone non-suppression after treatment and complete clinical recovery predicts early clinical relapse. Patients with recurrent depression tend to have consistency of their response to dexamethasone over multiple depressive episodes.