Serial postdexamethasone cortisol levels in a patient undergoing ECT

By employing a longitudinal design the authors have shown in this patient a quantitative, gradual improvement in postdexamethasone cortisol suppression that closely paralleled the improvement in depression. Although therapeutic results in depression can usually be achieved with 6-10 ECTs, the number of seizures required for clinical response may vary considerably among patients. It is of interest that a total of 9 ECTs was necessary in this case to normalize completely the HPA dysfunction, suggesting that the number of ECTs required for clinical improvement may be related to the number necessary for normalization of dexamethasone suppression.