Am J Psychiatry 1981; 138:1218-1221
Copyright © 1981 by American Psychiatric Association
Cortisol secretion and dexamethasone response in depression
GM Asnis, EJ Sachar, U Halbreich, RS Nathan, L Ostrow and FS Halpern
The authors administered 2 mg of dexamethasone at 11:00 p.m. to 37
unmedicated hospitalized endogenously depressed patients and assessed their
plasma cortisol response at 4:00 and 11:00 p.m. the next day. In addition,
on nondexamethasone days 26 of these patients had mean 24- hour plasma
cortisol concentration determinations from samples taken at 30-min
intervals and 32 had plasma determinations from a single sample taken at
4:00 and 11:00 p.m. Mean 24-hour plasma cortisol concentration was elevated
in 50%; only 7 of the 26 were dexamethasone resistant, and 6 of these 7
were hypersecretors. The authors suggest that dexamethasone resistance
reflects the abnormality of cortisol hypersecretion in depression and that
the 2-mg dexamethasone suppression test is a highly specific but not very
sensitive indicator of hypersecretion.
