The Dexamethasone Suppression Test in Depressive and Non-Depressive Patients with Fibromyalgia

Authors: Safinaz ATAOĞLU, Ahmet ATAOĞLU, Jale SARAÇ, Ferda ERDOĞAN, Aytekin SIR, Kemal NAS, Mustafa ÖZKAN

Abstract: In most healthy individuals, dexamethasone suppresses adrenal cortisol production. However, in patients with depression, non-suppression frequently occurs. It is considered to be a hyperactivity of the limbichypothalamic pituitary-adrenal (LHPA) axis. To investigate a possible link between fibromyalgia and depression on the basis of response to dexamethasone suppression test (DST), we administered the DST to 20 fibromyalgia patients with depression, 26 nondepressive patients with fibromyalgia and 20 controls. In the fibromyalgia patients with depression. at the mean 16.00 hr, post dexamethasone plasma cortisol level was found significant (LSD: 0.655: p<0.05). (LSD: 0.657: p<0.05), compared to non-depressive patients with fibromyalgia and the controls. There was no significant difference between post dexamethasone plasma cortisol levels in the non-depressive patients with fibromyalgia and control group (LSD: 0.655: p>0.05). In the fibromyalgia patients with depression, seven subjects had a non-suppressed response to the DST, which was significant relative to other two groups (P<0.05). In the non-depressive fibromyalgia group, only one subject had a non-suppressed response to the DST. In the control group, all subjects showed a suppressed response to the DST, There were no significant differences in the supression rates between the non-depressive patients with fibromyalgia and control group (P>0.05). Our findings show that fibromyalgia may not be related to hyperactivity of the LHPA axis.

Keywords: Fibromyalgia, Depression, Dexamethasone suppression test