Plasma dexamethasone concentrations and the dexamethasone suppression test

Ritchie, James C.; Belkin, Beth M.; Ranga, K.; Krishnan, Ranga; Nemeroff, Charles B.; Caroll, Bernard J.

doi:10.1016/0006-3223(90)90646-j

Cited by 56 publications

(29 citation statements)

References 27 publications

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“…The enhanced suppression of cortisol during the dexamethasone [36, 37] and prednisolone suppression test [38] supports the notion that increased functional activity of GR and possibly MR may have pathophysiological significance in CFS. However, as dexamethasone is metabolised via cortisol metabolic pathways, the enhanced cortisol suppression during the DST may therefore be caused not by GR upregulation but by reduced dexamethasone metabolism (as a consequence of the enzyme inhibition secondary to persistent hypocortisolaemia [39]).…”

Section: Hpa Axis Function In Patients With Cfsmentioning

confidence: 99%

A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome

2013

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Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been found in a high proportion of chronic fatigue syndrome (CFS) patients and includes enhanced corticosteroid-induced negative feedback, basal hypocortisolism, attenuated diurnal variation, and a reduced responsivity to challenge. A putative causal role for genetic profile, childhood trauma, and oxidative stress has been considered. In addition, the impact of gender is demonstrated by the increased frequency of HPA axis dysregulation in females. Despite the temporal relationship, it is not yet established whether the endocrine dysregulation is causal, consequent, or an epiphenomenon of the disorder. Nonetheless, given the interindividual variation in the effectiveness of existing biological and psychological treatments, the need for novel treatment strategies such as those which target the HPA axis is clear.

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Section: Hpa Axis Function In Patients With Cfsmentioning

confidence: 99%

A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome

2013

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“…Dexamethasone was assayed at Emory University, Georgia using a method previously described (Ritchie et al 1990). In this method, the 80 %, 50 % and 20 % binding points have averaged to 0n07, 0n33 and 1n46 ng\ml respectively.…”

Section: Biochemical Measuresmentioning

confidence: 99%

Hypothalamic–pituitary–adrenal axis function in patients with chronic depression

et al. 2002

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The HPA axis is not overtly abnormal in chronic depression. This contrasts with previous findings in acute depression and bipolar disorder and may suggest that the HPA axis abnormalities present in acute depression resolve, but are not accompanied by symptom resolution. Alternatively, a subgroup of depressives with less HPA dysfunction may progress to chronicity. This has implications for treatment and prognosis. The dex/CRH is a more sensitive test of HPA axis function than the DST in patients with chronic depression.

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“…Blood samples were drawn from a heparinized lock inserted into an antecubital vein for subsequent determination of blood alcohol concentrations by a modified alcohol dehydrogenase assay (22). Plasma cortisol levels were assessed by fluorescent polarization immunoassay (23). Systolic and diastolic blood pressure and pulse rate were taken with an electronic sphygmomanometer.…”

Section: Methodsmentioning

confidence: 99%