Tolerability of the dexamethasone-corticotropin releasing hormone test in major depressive disorder

Boadie W. Dunlop, Yara Betancourt, Elisabeth B. Binder, Christine Heim, Florian Holsboer, Marcus Ising, Melissa McKenzie, Tanja Mletzko, Hildegard Pfister, Charles B. Nemeroff, W. Edward Craighead, Helen S. Mayberg

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: The dexamethasone-corticotropin releasing hormone (Dex-CRH) test may differentially predict which depressed patients will respond to antidepressant medication. However, a comprehensive analysis of the safety of this test in psychiatric patients has not previously been performed. Methods: We conducted a pooled analysis of depressed patients in four clinical studies. Observed and subjectively reported side-effects in 454 patients were collected for 90. minutes following CRH administration. Pre-test electrocardiograms were available in 250 patients to assess cardiac safety. Descriptive statistics were performed to evaluate these safety data. Results: Eight-six (18.9%) subjects experienced no side-effects from the procedure. The mean number of side-effects per subject was 1.4 ± 1.0. The most frequent adverse events were: flushing (n=216, 47.6%), feeling of warmth (144, 31.7%), hyperpnea/tachypnea (108, 23.8%), palpitations (37, 8.1%), and tachycardia (28, 6.2%). Side-effects were consistently mild and brief in duration. There were no serious adverse events. Conclusion: The Dex-CRH test produces a mild, predictable side-effect profile, characterized by flushing, feelings of warmth, hyperpnea/tachypnea, palpitations, and tachycardia. These results provide reassurance that the Dex-CRH test is well tolerated in psychiatric patients.

Original languageEnglish
Pages (from-to)24-28
Number of pages5
JournalJournal of Psychiatric Research
Issue number1
StatePublished - Jan 2011
Externally publishedYes


  • Adverse event
  • Corticotropin releasing factor
  • Cortisol
  • Electrocardiogram
  • HPA axis
  • Predictor


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