Noradrenergic dysfunction and antidepressant treatment response.
The purpose of this study was to investigate differences in outcome following treatment with two different antidepressants in depressed patients according to their pretreatment hormonal response to clonidine. In all, 62 drug-free DSM-IV recurrent major depressed patients and 20 normal controls were studied. Patients were subsequently treated for 4 weeks with fluoxetine (n=28), or amitriptyline (n=34), and were then classified as responders or nonresponders according to their final Hamilton depression scale score. Compared to controls, depressed patients showed lower GH response to CLO (DeltaGH) (P<0.0002). One control (5%) and 35 depressed patients (56%) had blunted DeltaGH values. The efficacy of the two antidepressants was not significantly different: 15 patients responded to AMI (44%), seven patients responded to FLUOX (25%) (P>0.15). However, in the subgroup of patients with blunted DeltaGH levels, the rate of responders was higher for AMI (11/21) compared to FLUOX (1/14) treated patients (P<0.01). These results suggest that in depressed patients a blunted GH response to CLO could predict antidepressant response.
Corrêa
H
H
Centre Hospitalier, Section VIII, 68250, Rouffach, France. correa@task.com.br.
Duval
F
F
Claude
M M
MM
Bailey
P
P
Tremeau
F
F
Diep
T S
TS
Crocq
M A
MA
Castro
J O
JO
Macher
J P
JP
D000316:Adrenergic alpha-Agonists; D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003000:Clonidine; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D011863:Radioimmunoassay
D000316:Adrenergic alpha-Agonists; D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D019382:Human Growth Hormone; D000639:Amitriptyline; D003000:Clonidine; D016666:Fluvoxamine; D009638:Norepinephrine