Catecholamine Metabolism, Depressive Illness, and Drug Response

Identification of a Naturally Occurring Polymorphism in the Promoter Region of the Norepinephrine Transporter and Analysis in Major Depression

“…Many studies have reported altered NE levels in depressed patients (reviewed by Charney 1998). Studies of NE metabolites showed decreased urinary levels of MHPG (3-methoxy-4-hydroxyphenylglycol), the major metabolite of NE in unipolar patients, and elevated levels in bipolar patients during manic states (Maas et al 1972;Muscettola et al 1984). Investigations of NE metabolites in the cerebrospinal fluid (CSF) of depressed patients compared with healthy individuals led to so far conflicting results.…”

Stress, norepinephrine and depression

“…The bulk of the evidence suggests that metabolite changes play little or no role in the pathophysiology of depression. 30,31 Evidence of abnormalities of NE adrenoreceptors comes from untreated patients who attempt suicide. These people have a marked diminution in the mean peak response of growth hormone to clonidine challenge.…”

Biochemistry of Mental Depression

“…As for the urinary output of MHPG, the noradrenaline metabolite of the nervous system, Schildkraut (83,85), Maas and his colleagues (25,50,51), and Casper et al (13), claim that it is excreted in abnormally low amounts in depressed patients. This is all the more interesting because in some studies other catecholamine metabolites measured at the same time, such as metanephrine, normetanephrine and VMA, were present in the usual amounts.…”

“…The urinary concentration of MHPG has been investigated from still another standpoint, namely, its correlation with changes in mental state during the course of treatment. There have been some claims for the predictive value of urinary MHPG, to the effect that a low MHPG value is associated with improved status on an imipramine regime (8,51), a high value with failure. The low-MHPG patients, as a group, did not respond well to amitriptyline (8), but those excreting normal or elevated amounts of MHPG in the urine tended to improve with this anti-depressant drug (82).…”