Abstract
AbstractTo determine if accelerated dexamethasone elimination underlies dexamethasone suppression test (DST) Cortisol level increases reported with electroconvulsive therapy (ECT), 1- and 2-mg DSTs were compared in 12 consecutive male melancholies. Post-ECT nonsuppression occurred in none with 2 mg but in four ECT responders with 1 mg (p = 0.0192). Combining subjects from our prior 2-mg DST study, nonsuppression occurred in one sixth pre-ECT and none post-ECT, while mean DST Cortisol levels decreased (p = 0.043) from 4.00 μ/dL to 1.76 μ/dL. In contrast, mean 1-mg DST Cortisols were 6.04 μ/dL pre-ECT but 6.63 μ/dL post-ECT. With ECT, DST Cortisol variability should decrease as DST nonsuppression converts to suppression; variability indeed fell by 75% with μ(p < 0.0001), but showed no fall with 1 mg. These differences between DST doses indicate that, after ECT, 2 mg is adequate but 1 mg is not. Presumably, ECT anesthesia medications accelerate dexamethasone elimination.
Published Version
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