Abnormal dexamethasone suppression test in headaches: Effect of analgesic abuse

The response to dexamethasone suppression test (DST) in 13 subjects suffering from migraine without aura with coexisting chronic tension type headache, and abusing of instant-relief drugs was studied before and after analgesic withdrawal. Seventy-six per cent of the subjects was found to be non suppressor when abuser and 36% of them maintained the same response to DST after analgesic wash-out. These latter subjects showed a mild degree of depression and a daily pattern of plasma cortisol similar to that reported for depressed patients. These results suggest that in some patients headache and mood disorders coexist, possibly linked to a common psychobiological trait.