Melatonin response to atenolol administration in depression: indication of beta-adrenoceptor dysfunction in a subtype of depression.
OBJECTIVE
To investigate peripheral beta-adrenoceptor sensitivity in depression by assessing urinary melatonin pre- and post-administration of atenolol.


METHODS
Overnight urinary melatonin pre- and post-administration of 100 mg oral atenolol was assessed in 36 depressed subjects and 47 controls.


RESULTS
Baseline melatonin was significantly lower in depressed patients than controls (P=0.004). Melatonin following atenolol administration was strongly reduced in both groups (P < 0.0001). This reduction depends on whether the subject is a high or low (cutoff: 0.25 nmol/l) baseline melatonin excretor (P=0.025) and on whether he is depressed being a low excretor (P=0.048). A negative correlation (P=0.007) was found between melatonin decrease after atenolol and the Montgomery-Asberg Depression Rating Scale score.


CONCLUSIONS
Atenolol strongly reduces melatonin in depressed and control subjects; this decrease relates inversely to the severity of depressive symptoms. Furthermore, responsiveness to atenolol differs between low melatonin depressed patients and low excretor controls, alluding to beta-adrenoceptor up-regulation in a subtype of depression.
Paparrigopoulos
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Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece. egslelabath@hol.gr
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001262:Atenolol / Q000008:administration & dosage*; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008550:Melatonin / Q000378:metabolism* / Q000652:urine; D008875:Middle Aged; D011943:Receptors, Adrenergic, beta / Q000187:drug effects*; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists; D011943:Receptors, Adrenergic, beta; D001262:Atenolol; D008550:Melatonin