Post-dexamethasone cortisol correlates with severity of depression before and during carbamazepine treatment in women but not men

Objective: Previous studies show a state-dependent relationship between dep ression and post-dexamethasone suppression test (DST) cortisol level, as we ll as differences in DST response with age and gender. Method: In this study, 74 research in-patients with affective disorders wer e given the DST on placebo and in a subgroup following treatment with carba mazepine. Depression was evaluated twice daily with the Bunney-Hamburg (BH) rating scale. Data were examined for the total subject population, by gend er and by menopausal status in women. Results: A robust positive correlation was observed between depression seve rity and post-DST cortisol in pre- and postmenopausal females, but not in m ales. This relationship persisted in women when restudied on a stable dose of carbamazepine (n=42). Conclusion: The pathophysiological implications of this selective positive relationship between severity of depression and post-DST cortisol in women, but not men, should be explored further.