Maguire K P, Tuckwell V M, Schweitzer I, Tiller J W, Davies B M
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria, Australia.
Psychoneuroendocrinology. 1990;15(2):113-23. doi: 10.1016/0306-4530(90)90019-6.
Dexamethasone pharmacokinetics were measured in 19 depressed patients, 10 dexamethasone suppression test (DST) nonsuppressors and nine suppressors, following a 1 mg oral dose in tablet form at 2300 h. Median dexamethasone concentrations were significantly lower in the nonsuppressors from 3-16 hr post-administration. Nonsuppressors had a significantly lower area under the curve than suppressors, and plasma clearance was significantly faster in the nonsuppressors than in the suppressors. Eleven patients, six nonsuppressors and five suppressors, agreed to a repeat DST after clinical improvement when all six nonsuppressors had normal DST responses. There were no significant differences between the median dexamethasone concentrations, or any of the pharmacokinetic parameters measured, of the "normalising" nonsuppressors and the suppressors. Dexamethasone kinetics were altered in depressed nonsuppressors but became normal with remission of depressive symptoms and normalisation of the DST response.
在23:00时，对19名抑郁症患者（其中10名地塞米松抑制试验[DST]无抑制者和9名有抑制者）口服1毫克片剂形式的地塞米松后，测量其药代动力学。给药后3至16小时，无抑制者的地塞米松中位浓度显著低于有抑制者。无抑制者的曲线下面积显著低于有抑制者，且无抑制者的血浆清除率显著快于有抑制者。11名患者（6名无抑制者和5名有抑制者）在临床改善后同意重复进行DST，此时所有6名无抑制者的DST反应均正常。“恢复正常”的无抑制者与有抑制者的地塞米松中位浓度或任何测量的药代动力学参数之间无显著差异。抑郁症无抑制者的地塞米松动力学发生改变，但随着抑郁症状的缓解和DST反应恢复正常而变得正常。
