Am J Psychiatry 1986; 143:1398-1402
Copyright © 1986 by American Psychiatric Association
Failure of urinary MHPG levels to predict treatment response in patients with unipolar depression
PG Janicak, JM Davis, C Chan, E Altman and D Hedeker
The authors studied 64 depressed patients who were receiving a
vanillylmandelic acid (VMA)-free diet and underwent a washout period (mean,
24 days) before treatment. During the washout period, a mean of 2.5
multiple 24-hour urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) samples per
patient were collected. Thirty-four patients were then treated with a
"noradrenergic" antidepressant only (e.g., imipramine), and seven were
treated with a "serotonergic" antidepressant only (e.g., amitriptyline).
Twelve patients received combined drug treatment and 11 others
spontaneously remitted. Response to treatment was rated on a clinical
global evaluation scale from 1 (little or no response) to 7 (maximum
response). No relationship was found between response to treatment, type of
treatment, and the average pretreatment 24-hour urinary MHPG level. The
authors thus failed to confirm the hypothesis that a low MHPG level
predicts response to antidepressant treatment.
