The DST as a predictor of acute response to treatment with ECT, chlorimipramine, amitriptyline, and phenelzine

Plasma cortisol levels of 41 patients suffering from major depressive episodes were measured at 4 p.m. and 10 p.m. one day after administration of 1 mg dexamethasone at 10 p.m. Comparison of cortisol results to clinical improvement measured by the Beck Depression Inventory before and after 5 weeks of treatment with either ECT, chlorimipramine, amitriptyline, or phenelzine showed no difference between nonsuppressors and suppressors in relation to clinical improvement. Clinical prediction of the outcome of acute response to these treatments using an initial DST does not seem feasible.