Posted by Larry Hoover on February 6, 2009, at 13:26:12
In reply to Re: Long Term SSRI Use Has Destabilzed Me » Larry Hoover, posted by SLS on February 6, 2009, at 12:32:59
> Did you find any studies examining the dexamethasone suppression test (DST)?
Recent ones? There are very few of those.
> It might give a more pertinent measurement of HPA axis dysregulation than measuring blood or salivary cortisol levels.
>
> I tested positive on both.
>
>
> - ScottWhat I found was that dexamethasone suppression/nonsuppression isn't used as a stand-alone test very often any more. Usually the "measure" they're looking for is a subsequent response to CRH post-dexamethasone. Or a change in baseline cortisol resulting from dexamethasone exposure.
I honestly wonder if they've yet got any idea of just what is they're looking at, or looking for.
Here is a bit of recent stuff, one abstract, and two links to full-text articles. The latter link raises some interesting considerations.
Regards,
LarScientificWorldJournal. 2006 Oct 31;6:1398-404.
Combined dexamethasone suppression-corticotropin-releasing hormone stimulation test in studies of depression, alcoholism, and suicidal behavior.Sher L.
Division of Neuroscience, Department of Psychiatry, Columbia University, New York, USA. LS2003@columbia.eduThe hypothalamic-pituitary-adrenal (HPA) axis controls the secretion of corticotropin-releasing hormone (CRH), corticotropin (adrenocorticotropic hormone, ACTH), and cortisol. The dexamethasone suppression test (DST) is the most frequently used test to assess HPA system function in psychiatric disorders. Patients who have failed to suppress plasma cortisol secretion, i.e., who escape from the suppressive effect of dexamethasone, have a blunted glucocorticoid receptor response. After CRH became available for clinical studies, the DST was combined with CRH administration. The resulting combined dexamethasone suppression-corticotropin-releasing hormone stimulation (DST-CRH) test proved to be more sensitive in detecting HPA system changes than the DST. There is a growing interest in the use of the DEX-CRH test for psychiatric research. The DEX-CRH test has been used to study different psychiatric conditions. Major depression, alcoholism, and suicidal behavior are public health problems around the world. Considerable evidence suggests that HPA dysregulation is involved in the pathogenesis of depressive disorders, alcoholism, and suicidal behavior. Over the past 2 decades, there has been a shift from viewing excessive HPA activity in depression as an epiphenomenon to its having specific effects on symptom formation and cognition. The study of HPA function in depression, alcoholism, and suicidal behavior may yield new understanding of the pathophysiology of these conditions, and suggest new approaches for therapeutic interventions. The combined DEX-CRH test may become a useful neuroendocrinological tool for evaluating psychiatric patients.
Revisiting the Dexamethasone Suppression Test in unipolar major depression: an exploratory study
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=19014558Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17683542
poster:Larry Hoover
thread:874312
URL: http://www.dr-bob.org/babble/20090203/msgs/878492.html