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A Replication and New Findings

Giovanni Muscettola, MD; William Z. Potter, MD, PhD; David Pickar, MD; Frederick K. Goodwin, MD

Arch Gen Psychiatry. 1984;41(4):337-342.

Abstract
• We studied group and subgroup differences in urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) levels in patients with major affective disorder (66 depressed, 13 manic) and normal volunteers (27 subjects). Bipolar I depressed patients excreted less MHPG than unipolar depressed patients, manic patients, or normal volunteers. The mean (±SEM) MHPG excretion rate was 1.44±0.10 mg/day in 19 depressed bipolar I patients, 1.79±0.11 mg/day in 28 unipolar depressed patients, 2.11±0.19 mg/day in 13 manic patients, and 1.85±0.12 mg/day in 27 normal volunteers. Other sources of variance that affected urinary MHPG levels did not explain subgroup or state differences. There was only a trend for a low pretreatment MHPG level to be associated with positive response to imipramine hydrochloride or desipramine hydrochloride in the 19 patients treated with these drugs. The application of this biological test value for prediction of differential response to antidepressant drugs would therefore seem premature.

Author Affiliations
From the Clinical Psychobiology Branch (Drs Muscettola and Potter), the Clinical Neuroscience Branch (Dr Pickar), and the Intramural Research Program (Dr Goodwin), National Institute of Mental Health (NIMH), Bethesda, Md. Dr Muscettola is now with the Department of Psychiatry, Second Medical School, University of Naples, Italy.

Footnotes
Accepted for publication Dec 14, 1983.

Reprint requests to Clinical Psychobiology Branch, NIMH, Bldg 10, Room 4S-239, 9000 Rockville Pike, Bethesda, MD 20205 (Dr Potter).

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