We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Errors in Administration of the Dexamethasone Suppression Test-Reply

John F. Greden, MD; Steven C. Dilsaver, MD
Arch Gen Psychiatry. 1984;41(7):725-726. doi:10.1001/archpsyc.1984.01790180095020.
Text Size: A A A
Published online


In Reply.—  We concur with Dewan et al that withdrawal of certain medications may produce neuroendocrine changes, including the occasional nonsuppression in response to the DST. We caution that this finding is still quite tentative, however. In our report, when three of our 21 DST-nonsuppressive patients escaped only after tricyclic antidepressants were withdrawn, we hypothesized that this was due to a secondary cholinergic overdrive accompanying an anticholinergic withdrawal syndrome. If valid, this hypothesis should extend to any medication possessing anticholinergic properties. This would include the neuroleptic piperacetazine, used by Devanand et al1 to treat their patient. Thus, their observation is compatible with ours. In our research setting, we already have included recent antidepressant withdrawal as a potential exclusion criterion for DST results. Paradoxically, the "problem" of medication withdrawal might be more prevalent in research settings than in clinical programs, because research methods commonly emphasize drug washout periods.These observations also hint


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.