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Demented patients were investigated by blood sampling at 10 occasions during a 24-hour period. Serum levels of melatonin and cortisol were determined. One patient with probable vascular dementia had a severely disorganized sleep-wake schedule and showed disturbed patterns of serum melatonin and cortisol. After withdrawal of alprenolol, substitution of a vitamin B12 deficiency and cataract surgery, the patient regained normal sleep habits and a normal circadian pattern of serum cortisol and melatonin. A patient with frontal lobe dementia and a disorganized sleep-wake schedule showed a disturbed melatonin rhythm, unexpected cotisol peaks and a disability to suppress melatonin by light. Two Alzheimer patients with regular sleep habits had normal circadian patterns of serum melatonin and cortisol. [ABSTRACT FROM AUTHOR]

OBJECTIVEMost patients with fibromyalgic syndrome (FMS) complain of sleep disturbances, fatigue, and pain. These symptoms might be a consequence of changed melatonin (MT) secretion, since MT is known to have sleep promoting properties. Moreover, serum concentrations of two MT precursors (tryptophan and serotonin) — affecting both sleep and pain perception — appear to be low in patients with FMS. Therefore, the objective of this investigation was to study whether serum MT (s-MT) level is also low in these patients. DESIGNEight patients with FMS and 8 healthy sex-, BMI-, and age-matched controls were included in the study. s-MT concentrations were determined every second hour between 1800 and 0800 h. Urine was collected between 2200 and 0700 h for determination of urinary MT excretion. To evaluate total MT secretion between 1800 and 0800 h and MT secretion during the hours of darkness (between 23 and 07 h) individual MT areas under the curve (AUC) were calculated and expressed as group means. RESULTSThe FMS patients had a 31% lower MT secretion than healthy subjects during the hours of darkness (MT AUC 2300–0700 h (mean ± SEM): 1.70 ± 0.17 vs 2.48 ± 0.38 nmol/l; P < 0.05). Also the s-MT peak value was significantly lower in the patient group: 0.28 ± 0.03 vs 0.44 ± 0.06 nmol/l; P < 0.05). CONCLUSIONPatients with fibromyalgic syndrome have a lower melatonin secretion during the hours of darkness than healthy subjects. This may contribute to impaired sleep at night, fatigue during the day, and changed pain perception. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the discriminative power of a series of variables (including determination of depressive symptomatology by means of a visual analogue scale, determination of personality traits by means of the Karolinska Scales of Personality, determination of monoamine metabolites in CSF, platelet MAO activities, serum cortisol before and after dexamethasone suppression and urinary melatonin) in differentiating (a) chronic pain patients from healthy subjects, and (b) patients with idiopathic pain syndromes from patients with neurogenic pain syndromes. Separately each of the measures gave a significant but often low contribution to the discrimination, while a combination of several measures gave a complete discrimination both between healthy subjects and patients with chronic pain syndromes and between patients with idiopathic and neurogenic pain syndromes, respectively. [ABSTRACT FROM AUTHOR]

We studied the effect of phototherapy on body weight in 4 overweight women. Melatonin was measured in the serum and urine before and after 1 hr of bright light (350 cd/m2). Psychiatric self-ratings with the Comprehensive Psychopathological Rating Scale (CPRS) and Visual Analog Scale (VAS) were performed. Phototherapy (1,500 lux) was given daily at 7–9 a.m. for 10 days and thereafter twice weekly for another 4 1/2 weeks. Three of the 4 women reduced their net weight (1.5–2.4 kg) and improved in mood. All were sensitive to light. The findings indicate that phototherapy affects the melatonin-serotonin system and carbohydrate regulation and may reduce body weight. [ABSTRACT FROM AUTHOR]