Drugs and the DST: need for a reappraisal

It has generally been assumed that psychotropic drugs do not influence results on the dexamethasone suppression test (DST), except in some specific situations. Yet they directly affect the activity of many neurotransmitter systems, which in turn regulate hypothalamic-pituitary-adrenal (HPA) axis functioning. Several reports have shown correlations between the intake of or recent withdrawal from psychoactive substances and changes in DST results. A review of the DST literature reveals that these effects have not been controlled in most DST studies. It is therefore possible that the consequences of intake of psychotropic agents may have contributed to the debate surrounding the DST by producing unappreciated spurious DST results.