THE DEXAMETHASONE SUPPRESSION TEST AND TREATMENT OUTCOME IN ELDERLY DEPRESSED-PATIENTS PARTICIPATING IN A PLACEBO-CONTROLLED MULTICENTER TRIAL INVOLVING MOCLOBEMIDE AND NORTRIPTYLINE

The dexamethasone suppression test (DST) was conducted in 95 elderly D SM-III-R depressed patients randomized for treatment with moclobemide (MOC; 400 mg daily), nortriptyline (NT; 75 mg daily), or placebo (PBO) in a 7-week double-blind multicenter study. Patients were assessed we ekly using various clinical scales, including the 17-item Hamilton Dep ression Rating Scale. The DST was administered at baseline and at the end of treatment. At baseline, no relationship was found between DST s tatus and the various clinical scales used, At the end of treatment, s uppressors (DST-) had significantly improved clinical ratings compared to nonsuppressors (DST+), and were mostly found among those treated w ith NT (71%) as compared to MOC (41%) or PBO (33%) (p < .03), On the o ther hand, baseline DST measures influenced treatment outcome; DST+ pa tients had a greater number of treatment responders to NT (48%) than M OC (19%) or PBO (20%) (p < .07). For DST- patients, the situation was reversed: NT, 7%; MOC, 31%. Postdexamethasone cortisol levels were low er in MOC responders (p < .07), An interaction was found between DST a nd drug-specific response, The DST may be a useful adjunct for predict ing and evaluating the outcome of antidepressant therapy. (C) 1997 Soc iety of Biological Psychiatry.