Dexamethasone Suppression Test and Response to Antidepressants in Depressed Outpatients

Abstract

To the Editor: Some 25 to 60 per cent of patients with major depression have hypothalamic-pituitary-adrenal overactivity, manifested by nonsuppression of Cortisol, after overnight administration of dexamethasone.¹ Some workers think that this nonsuppression of cortisol represents a specific laboratory diagnosis of endogenous depression.² Recent reports^{3 , 4} have suggested that abnormal results on the dexamethasone suppression test may be predictive of a better response to tricyclic antidepressants, and there have been suggestions⁵ that the test results may assist in the precise selection of antidepressants. Brown and colleagues⁵ suggested that depressed patients with abnormal results on the dexamethasone suppression test responded preferentially . . .