Peselow E D, Stanley M, Filippi A M, Barouche F, Goodnick P, Fieve R R
Department of Psychiatry, New York University School of Medicine, New York.
Br J Psychiatry. 1989 Nov;155:667-72. doi: 10.1192/s0007125000018171.
We evaluated the dexamethasone suppression test (DST) as a predictor of response to drugs and placebo in 105 patients, in a large double-blind placebo-controlled out-patient trial to determine the efficacy of paroxetine HCl, a selective serotonin reuptake inhibitor, compared with that of imipramine HCl and placebo. The presence of a positive or negative DST did not predict response to either paroxetine or imipramine. However, a positive DST predicted a poorer response to placebo: only 3 out of 18 patients who showed DST non-suppression responded to placebo, as opposed to 11 out of 21 who exhibited DST suppression (P less than 0.05). A positive DST was associated with a 61% response to drugs and a 16% response to placebo. This finding suggests that the presence of a positive DST implies the need for active somatic treatment.
在一项大型双盲安慰剂对照门诊试验中，我们评估了地塞米松抑制试验（DST）作为105例患者对药物和安慰剂反应预测指标的作用，该试验旨在确定选择性5-羟色胺再摄取抑制剂盐酸帕罗西汀与盐酸丙咪嗪及安慰剂相比的疗效。DST结果呈阳性或阴性均不能预测对帕罗西汀或丙咪嗪的反应。然而，DST结果呈阳性预测对安慰剂反应较差：18例DST未被抑制的患者中只有3例对安慰剂有反应，而21例DST被抑制的患者中有11例对安慰剂有反应（P<0.05）。DST结果呈阳性的患者对药物的反应率为61%，对安慰剂的反应率为16%。这一发现表明，DST结果呈阳性意味着需要积极的躯体治疗。
