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The dexamethasone suppression test and response to placebo.
Journal of Clinical Psychopharmacology
|October 1, 1986
Summary
The dexamethasone suppression test (DST) did not predict antidepressant response. However, a positive DST indicated a poorer response to placebo in depressed patients, suggesting active treatment may be necessary.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- The dexamethasone suppression test (DST) is a biomarker used in diagnosing depression.
- Its predictive value for treatment response remains under investigation.
Purpose of the Study:
- To evaluate the predictive value of the DST for treatment response in depressed inpatients.
- To assess if DST results predict response to sertraline, oxaprotiline, or placebo.
Main Methods:
- Two double-blind, placebo-controlled trials involving 61 depressed inpatients.
- Patients were randomized to sertraline, oxaprotiline, or placebo for 4 weeks.
- Initial DST results were analyzed against treatment outcomes.
Main Results:
- The DST was not predictive of response to sertraline or oxaprotiline.
- A positive DST significantly predicted a poorer response to placebo compared to a negative DST.
- This was observed in 17 patients completing at least 3 weeks of placebo treatment.
Conclusions:
- The DST may not predict response to pharmacotherapy in depression.
- A positive DST suggests a lower likelihood of remission with placebo, indicating a need for active somatic treatment.
- Further research is warranted to confirm these preliminary findings.