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Abstract
We compared early biophase kinetics of dexamethasone in 33 patients with a major depression
who received a DST either by an oral (n = 20) or an intravenous (n = 13) route. After an oral DST, the dexamethasone kinetics between 14 suppressors
and 6 nonsuppressors were indistinguishable during the early distribution phase. However,
elimination of dexamethasone from the circulation was significantly enhanced in DST
nonsuppressors, resulting in an association of decreased plasma dexamethasone with
elevated post-DST cortisol levels. Following intravenous DST administration, we identified
5 nonsuppressors and 8 suppressors whose plasma dexamethasone kinetics were indistinguishable,
and during the elimination phase, were in the same order of magnitude as those of
nonsuppressors after an oral DST. We suggest that the actual plasma concentration
at the conventional post-DST sampling times does not reflect the biopotency of the
test drug to suppress the pituitary adrenocortical activity. Plasma dexamethasone
concentrations after an oral DST that were associated with nonsuppressed cortisol
seem to be coherent phenomena of the underlying endocrine disturbance, the precise
nature of which deserves further study.
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Article info
Publication history
Received in revised form:
February 4,
1987
Received:
July 26,
1986
Footnotes
☆Part of this work was presented at the ISPNE-Congress, Bergen, Norway, June 28–July 4 1986
Identification
Copyright
© 1987 Published by Elsevier Inc.