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The Effects of Dexamethasone on Plasma Homovanillic Acid and 3-Methoxy-4-hydroxyphenylglycol Evidence for Abnormal Corticosteroid-Catecholamine Interactions in Major Depression

Owen M. Wolkowitz, MD; Allen R. Doran, MD; Allan Breier, MD; Alec Roy, MB; David C. Jimerson, MD; Mary E. Sutton; Robert N. Golden, MD; Steven M. Paul, MD; David Pickar, MD
Arch Gen Psychiatry. 1987;44(9):782-789. doi:10.1001/archpsyc.1987.01800210026004.
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• We investigated the possible interactions between corticosteroids and catecholamines in depression by studying the effects of the synthetic glucocorticoid dexamethasone on plasma levels of homovanillic acid (HVA) and 3-methoxy-4--hydroxyphenylglycol (MHPG) in a group of depressed patients and normal controls. In comparison with metabolite levels on a control day, normal controls showed a significant dexamethasone-induced increase in the plasma HVA level and a trend toward a decrease in the plasma MHPG level at 4 PM following dexamethasone administration (1 mg orally at 11 PM). Conversely, depressed patients, particularly those with psychotic features, showed a significant dexamethasone-induced increase in the plasma MHPG level and a blunting of the plasma HVA response relative to the normal controls. Dexamethasoneinduced increases in the plasma MHPG level were directly correlated with the severity of depressive symptoms and with postdexamethasone cortisol levels in the depressed patients. These data suggest abnormal corticosteroid-catecholamine interactions in depression and, specifically, in depressed patients with psychotic features.


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