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The Predictive Value of the Dexamethasone Suppression Test

1989; Cambridge University Press; Volume: 155; Issue: 05 Linguagem: Inglês

10.1192/s0007125000018171

1472-1465

Eric D. Peselow, Michael Stanley, Ann-Marie Filippi, F Barouche, Paul J. Goodnick, Ronald R. Fieve,

Electroconvulsive Therapy Studies

We evaluated the dexamethasone suppression test (DST) as a predictor of response to drugs and placebo in 105 patients, in a large double-blind placebo-controlled out-patient trial to determine the efficacy of paroxetine HCI, a selective serotonin reuptake inhibitor, compared with that of imipramine HCI and placebo. The presence of a positive or negative DST did not predict response to either paroxetine or imipramine. However, a positive DST predicted a poorer response to placebo: only 3 out of 18 patients who showed DST non-suppression responded to placebo, as opposed to 11 out of 21 who exhibited DST suppression ( P <0.05). A positive DST was associated with a 61% response to drugs and a 16% response to placebo. This finding suggests that the presence of a positive DST implies the need for active somatic treatment.