Drug Discovery in Psychiatry: Rethinking Conventional Wisdom

Ghaemi, S. Nassir

doi:10.1177/07067437221112907

Cited by 2 publications

(1 citation statement)

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“…These factors are the cause of the heterogeneous patient populations used in drug development and the resulting meager results [ 111 ]. In addition to carefully characterized patients on the psychopathology level, any robust biomarker, such as an improved DST, would be very helpful in the generation of biologically more homogenous patient populations, thus enhancing the chances of success [ 112 ].…”

Section: Possible Applications Of An Improved and Validated Dstmentioning

confidence: 99%

Cortisol and the Dexamethasone Suppression Test as a Biomarker for Melancholic Depression: A Narrative Review

Schumacher¹,

Santambrogio

2023

JPM

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The dexamethasone suppression test (DST) assesses the functionality of the HPA axis and can be regarded as the first potential biomarker in psychiatry. In 1981, a group of researchers at the University of Michigan published a groundbreaking paper regarding its use for diagnosing melancholic depression, reporting a diagnostic sensitivity of 67% and a specificity of 95%. While this study generated much enthusiasm and high expectations in the field of biological psychiatry, subsequent studies produced equivocal results, leading to the test being rejected by the American Psychiatric Association. The scientific reasons leading to the rise and fall of the DST are assessed in this review, suggestions are provided as to how the original test can be improved, and its potential applications in clinical psychiatry are discussed. An improved, standardized, and validated version of the DST would be a biologically meaningful and useful biomarker in psychiatry, providing a tool for clinicians caring for depressed patients in the areas of diagnosis, treatment, and prognosis, and predicting the risk of suicide. Additionally, such a test could be a crucial part in the generation of biologically homogenous patient cohorts, necessary for the successful development of new psychotropic medications.

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Section: Possible Applications Of An Improved and Validated Dstmentioning

confidence: 99%