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Their Effects on Norepinephrine Metabolism in Patients With Primary, Major Depressions

Markku Linnoila, MD, PhD; Farouk Karoum, PhD; Norman Rosenthal, MD; William Z. Potter, MD, PhD

Arch Gen Psychiatry. 1983;40(6):677-680.

Abstract
• Effects of electroconvulsive treatment (ECT) and lithium carbonate on norepinephrine metabolism were investigated in eight patients with primary, major depressions. A series of 12 ECTs reduced urinary norepinephrine and normetanephrine output significantly, and showed a tendency to reduce urinary vanillylmandelic acid output as well as whole-body norepinephrine turnover. Treatment with lithium carbonate significantly reduced urinary norepinephrine, normetanephrine, 3-methoxy-4-hydroxyphenylglycol, and vanillylmandelic acid output as well as whole-body norepinephrine turnover. These findings point to a common effect of antidepressant treatments since they are similar to results produced by administration of three other types of antidepressant drugs: clorgiline, a specific monoamine oxidase A inhibitor; desipramine, a relatively specific norepinephrine reuptake inhibitor; and zimelidine, a relatively specific serotonin reuptake inhibitor. These drugs reduce total production of norepinephrine and/or its major metabolites in depressed patients. Thus, five antidepressant treatments with different mechanisms of action have a common overall effect on the system.

(Arch Gen Psychiatry 1983;40:677-680)

Author Affiliations
From the Clinical Psychobiology (Drs Linnoila, Rosenthal, and Potter) and Adult Psychiatry (Dr Karoum) Branches, National Institute of Mental Health, Bethesda, Md.

Footnotes
Accepted for publication Nov 26, 1982.

Reprint requests to Room 4S-239, Bldg 10, National Institute of Mental Health, Bethesda, MD 20205 (Dr Linnoila).

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