1. Noradrenergic function and clinical outcome in antidepressant pharmacotherapy.
- Author
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Miller HL, Ekstrom RD, Mason GA, Lydiard RB, and Golden RN
- Subjects
- Adrenergic Uptake Inhibitors administration & dosage, Adrenergic Uptake Inhibitors adverse effects, Depression physiopathology, Depression urine, Fluvoxamine administration & dosage, Fluvoxamine adverse effects, Humans, Imipramine administration & dosage, Imipramine adverse effects, Melatonin analogs & derivatives, Melatonin urine, Pineal Gland metabolism, Selective Serotonin Reuptake Inhibitors administration & dosage, Selective Serotonin Reuptake Inhibitors adverse effects, Treatment Outcome, Antidepressive Agents administration & dosage, Antidepressive Agents adverse effects, Depression drug therapy, Melatonin metabolism, Norepinephrine metabolism, Pineal Gland drug effects
- Abstract
Controversy remains regarding the role of noradrenergic systems in determining clinical response to antidepressant pharmacotherapy. Pineal gland production of melatonin can serve as a physiologic index of noradrenergic function. The aim of this study was to examine the effects of antidepressant treatment on 24-hour urinary excretion of the principle metabolite of melatonin, 6-sulfatoxymelatonin in treatment responders and nonresponders. Twenty-four outpatients meeting DSM-III-R criteria for Major Depression received treatment with either fluvoxamine or imipramine for 6 weeks while participating in a placebo-controlled double-blind clinical trial. Twenty-four hour excretion of 6-sulfatoxymelatonin was measured at baseline and at the conclusion of the treatment trial. Changes in urinary excretion of 6-sulfatoxymelatonin distinguished antidepressant responders from nonresponders, with a significant increase observed in the former group and a significant decrease in the latter. The degree of clinical response was correlated with the change in 6-sulfatoxymelatonin excretion. These results suggest that enhanced noradrenergic function may play an important role in determining clinical response to antidepressant pharmacotherapy.
- Published
- 2001
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