Specificity of plasma HVA response to dexamethasone in psychotic depression

Owen M. Wolkowitz, Allen Doran, Alan Breier, Alec Roy, David Pickar

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Earlier reports have suggested that dexamethasone significantly increases levels of plasma homovanillic acid (HVA) in normal subjects, but that this effect may be altered in some depressed patients. To investigate the specificity of such alterations, we administered dexamethasone (1 mg p.o. at 11 p.m.) to 33 normal subjects, 27 depressed patients (8 with psychotic features), and 16 schizophrenic patients. Plasma for assay of cortisol and HVA was obtained at 4 p.m. before and on the day following dexamethasone administration. Dexamethasone induced significant increases in plasma HVA in the normal subjects and in the schizophrenic patients, but not in the depressed patients. Indeed, psychotically depressed patients tended to show a dexamethasone-associated decrease in plasma levels of HVA. In contrast to cortisol "suppression" or "nonsuppression", dexamethasone-induced changes in plasma levels of HVA (i.e., increases or decreases) sensitively and specifically discriminated between patients with affective and nonaffective psychoses.

Original languageEnglish (US)
Pages (from-to)177-186
Number of pages10
JournalPsychiatry Research
Issue number2
StatePublished - 1989
Externally publishedYes


  • depression
  • dexamethasone
  • Homovanillic acid
  • psychotic depression
  • schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • General Psychology


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