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Abstract
The bioavailability of dexamethasone (DEX) has recently been demonstrated to be a
critical factor in determining Dexamethasone Suppression Test (DST) status in psychiatric
patients. This brief review focuses on several aspects of DEX bioavailability as they
relate to the use of the DST in neuroendocrine research. Several methodologies, including
radioimmunoassay, high-performance liquid chromatography, and gas chromatography-mass
spectrometry are available for quantification of DEX in biological fluids, although
few detailed comparisons between methods have been reported. Surprisingly, little
systematic research on the metabolism of DEX has been reported, but it appears that
hepatic rather than renal mechanisms are the major source of DEX elimination. The
marked variability in serum DEX levels following oral administration in psychiatric
patients is also observed in normal controls and patients with Cushing's syndrome.
A variety of drugs can modify serum DEX levels and thereby alter the effectiveness
of DEX in suppressing serum cortisol levels. Simultaneous measurement of serum DEX
and cortisol levels appears to be necessary for the appropriate evaluation of DST
results. This procedure may help explain many of the inconsistencies in recent DST
research.
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Article info
Publication history
Received in revised form:
July 14,
1986
Received:
March 27,
1986
The excellent secretarial assistance of Ms. Lee Mason is greatly appreciated.Footnotes
☆Supported by NIMH Grants MH-41683-01 and MH-41684. H.Y.M. is a recipient of USPHS Research Career Scientist Award MH 47,808.
Identification
Copyright
© 1987 Published by Elsevier Inc.
