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Plasma MHPG and AMDP depression relations, evolution and drug effect in a follow‐up study of depressed patients

Plasma MHPG levels and AMDP rating score were measured in depressed patients before treatment, and a follow‐up study was performed during the next 3 months of drug therapy to detect possible relationships between the parameters. Before treatment, MHPG levels were moderately lower in depressed than in age‐ and sex‐matched normal subjects. Bipolar depressed patients presented the lowest values. In the three diagnostic groups (DSM‐III), antidepressant treatment resulted in a significant decrease of mean levels in unipolar and dysthymic depressed, but not in bipolar depressed patients. When the type of antidepressant was considered, imipramine (IMI)‐ or desipramine (DMI)‐treated patients, but not fluvoxamine (FLU)‐treated, also decreased their mean values of MHPG, with minor difference between improved and non‐improved patients. However, when patients were grouped according to their pattern groups (low (LL), high (HL), or normal (NL) baseline MHPG levels), interesting information emerged: improvement of clinical state of patient (i.e. 60 per cent of AMDP baseline reduction) resulted in ‘normalization’ of erratic values (HL and NL) whatever the treatment, while in non‐improved patients such evolution was not observed. In the latter group, change in MHPG levels was only drug‐related (decrease in IMI–DMI‐treated and no change in FLU‐treated values). Results suggest that mechanisms of buffering NA activity were lost in endogenous depression and restored in patients responding to treatment.