Noradrenergic dysfunction and antidepressant treatment response

The purpose of this study was to investigate differences in outcome followi ng treatment with two different antidepressants in depressed patients accor ding to their pretreatment hormonal response to clonidine. In all, 62 drug- free DSM-IV recurrent major depressed patients and 20 normal controls were studied. Patients were subsequently treated for 4 weeks with fluoxetine (n= 28), or amitriptyline (n=33), and were then classified as responders or non responders according to their final Hamilton depression scale score. Compar ed to controls, depressed patients showed lower CU response to CLO (Delta G H) (P<0.0002). One control (5%) and 35 depressed patients (56%) had blunted <Delta>GHI values. The efficacy of the two antidepressants was not signifi cantly different: 15 patients responded to AMI (44%), seven patients respon ded to FLUOX (25%) (P>0.15). However, in the subgroup of patients with blun ted Delta GH levels, the rate of responders was higher for AMI (11/21) comp ared, to FLUOX (1/14) treated patients (P<0.01). These results suggest that in depressed patients a blunted GH It sponse to CLO could predict antidepr essant response. <(c)> 2001 Elsevier Science B.V. All rights reserved.