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The Dexamethasone Suppression Test for the Detection, Diagnosis, and Management of Depression

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Grant support: The Clinical Efficacy Assessment Project is funded by the John A. Hartford Foundation.

Quotations in advertisements and other commercial publications of text in the American College of Physicians position papers and Clinical Efficacy Assessment Project Recommendations must be with expressed permission from the Department of Health and Public Policy, American College of Physicians, 4200 Pine Street, Philadelphia, PA 19104.

▸Requests for reprints should be sent to Linda Johnson White; Clinical Efficacy Assessment Project, Department of Health and Public Policy, American College of Physicians, 4200 Pine Street; Philadelphia, PA 19104.

Ann Intern Med. 1984;100(2):307-308. doi:10.7326/0003-4819-100-2-307
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The dexamethasone suppression test for the detection, diagnosis, and management of depression consists of two steps. Dexamethasone is administered orally, 1 mg in tablet form, at 2300 h. Then, samples of venous blood are drawn at 0800 h, 1600 h, and 2300 h the following day; in outpatients, only a 1600 h venous blood sample commonly is obtained.

A serum cortisol level greater than 4.5 to 5 µg/dL for any of the blood samples is abnormal and represents a positive test, depending on the assay used (1). Thus, it is important that the laboratory method used be precise and accurate


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