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Robert N. Golden, MD; Sanford P. Markey, PhD; Emile D. Risby, MD; Matthew V. Rudorfer, MD; Rex W. Cowdry, MD; William Z. Potter, MD, PhD

Arch Gen Psychiatry. 1988;45(2):150-154.

Abstract
• The effects of antidepressant treatment on noradrenergic function were studied in 27 patients with a major affective disorder. Twenty-four-hour urinary excretion of 6-hydroxymelatonin and "whole-body norepinephrine (NE) turnover," ie, 24-hour urinary output of NE and its major metabolites 3-methoxy-4-hydroxyphenylglycol, vanillylmandelic acid, and normetanephrine, were measured before and after treatment with the tricyclic desipramine hydrochloride, the aminoketone bupropion hydrochloride, the nonselective monoamine oxidase (MAO) inhibitor tranylcypromine sulfate, and the specific MAO type A inhibitor clorgiline. 6-Hydroxymelatonin excretion increased following antidepressant treatment, while at the same time whole-body NE turnover was reduced. These findings support the hypothesis that antidepressant therapy increases noradrenergic "efficiency," in that functional output, as measured by 6-hydroxymelatonin, is maintained while total NE production is decreased.

Author Affiliations
From the Laboratory of Clinical Science (Drs Golden, Markey, Risby, Rudorfer, Cowdry, and Potter) and the Office of the Clinical Director (Dr Cowdry), National Institute of Mental Health, Bethesda, Md. Dr Golden is now with the University of Mental Health, Bethesda, Md. Dr Golden is now with the University of North Carolina School of Medicine, Chapel Hill.

Footnotes
Accepted for publication July 20, 1987.

Read in part before the 137th annual meeting of the American Psychiatric Association, Los Angeles, May 8, 1984; and at the 87th annual meeting of the American Society for Clinical Pharmacology and Therapeutics, Washington, DC, March 20, 1986.

Reprint requests to Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC 27514 (Dr Golden).

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