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Matsumoto Y, Hino A, Kumadaki K, Itani O, Otsuka Y, Kaneita Y. Relationship between Telework Jetlag and Perceived Psychological Distress among Japanese Hybrid Workers. Clocks Sleep 2023; 5:604-614. [PMID: 37873841 PMCID: PMC10667991 DOI: 10.3390/clockssleep5040040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
Social jetlag is associated with physical and mental health problems. With the increased popularity of telework, we investigated a specific form of social jetlag that we termed "telework jetlag". This study aimed to clarify the relationship between telework jetlag-the difference in sleep and wake-up times between in-office and telework days-and mental health problems among Japanese hybrid workers. A cross-sectional study was conducted with 1789 participants from October to December 2021 using an online-based questionnaire. Telework jetlag, defined as the difference in the midsleep point between in-office and telework days, was investigated using two groups according to telework jetlag-those lagging <1 h versus ≥1 h. We used the six-item Kessler Scale as a nonspecific psychological distress scale for the outcome. Telework jetlag was significantly associated with psychological distress, and the ≥1 h group had a higher risk (odds ratio: 1.80) of developing high psychological distress (HPD) than the <1 h group in the multivariate analysis. Since most teleworkers are forced to have a hybrid work style that mixes going to work and teleworking, telework jetlag must be addressed to maintain the health of teleworkers.
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Affiliation(s)
- Yuuki Matsumoto
- Department of Nursing, School of Medicine, Kurume University School of Nursing, Kurume 830-0003, Japan
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - Kunitaka Kumadaki
- Department of Internal Medicine, Univer sity of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
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Chauhan S, Barbanta A, Ettinger U, Kumari V. Pineal Abnormalities in Psychosis and Mood Disorders: A Systematic Review. Brain Sci 2023; 13:brainsci13050827. [PMID: 37239299 DOI: 10.3390/brainsci13050827] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The pineal gland (PG) is a small interhemispheric brain structure that influences human physiology in many ways, most importantly via secretion of the hormone melatonin which is known to regulate sleep and wakefulness. Here, we systematically reviewed existing neuroimaging studies of PG structure, and/or melatonin release (MLT) in psychosis and mood disorders. Medline, PubMed, and Web of Science databases were searched (on 3 February 2023), yielding 36 studies (8 PG volume, 24 MLT). The findings showed smaller-than-normal PG volume in people with schizophrenia, regardless of symptom severity and illness stage; and smaller-than-normal PG volume in major depression, with some indication of this being present only in certain subgroups, or in those with high scores on the 'loss of interest' symptom. There was considerable evidence of lower-than-normal MLT as well as aberrant MLT secretion pattern in schizophrenia. A similar picture, though less consistent than that seen in schizophrenia, emerged in major depression and bipolar disorder, with some evidence of a transient lowering of MLT following the initiation of certain antidepressants in drug-withdrawn patients. Overall, PG and MLT aberrations appear to represent transdiagnostic biomarkers for psychosis and mood disorders, but further work is needed to establish their clinical correlates and treatment implications.
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Affiliation(s)
- Satyam Chauhan
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London UB8 3PH, UK
| | - Andrei Barbanta
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London UB8 3PH, UK
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, 53111 Bonn, Germany
| | - Veena Kumari
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London UB8 3PH, UK
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Won E, Na KS, Kim YK. Associations between Melatonin, Neuroinflammation, and Brain Alterations in Depression. Int J Mol Sci 2021; 23:ijms23010305. [PMID: 35008730 PMCID: PMC8745430 DOI: 10.3390/ijms23010305] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 12/14/2022] Open
Abstract
Pro-inflammatory systemic conditions that can cause neuroinflammation and subsequent alterations in brain regions involved in emotional regulation have been suggested as an underlying mechanism for the pathophysiology of major depressive disorder (MDD). A prominent feature of MDD is disruption of circadian rhythms, of which melatonin is considered a key moderator, and alterations in the melatonin system have been implicated in MDD. Melatonin is involved in immune system regulation and has been shown to possess anti-inflammatory properties in inflammatory conditions, through both immunological and non-immunological actions. Melatonin has been suggested as a highly cytoprotective and neuroprotective substance and shown to stimulate all stages of neuroplasticity in animal models. The ability of melatonin to suppress inflammatory responses through immunological and non-immunological actions, thus influencing neuroinflammation and neurotoxicity, along with subsequent alterations in brain regions that are implicated in depression, can be demonstrated by the antidepressant-like effects of melatonin. Further studies that investigate the associations between melatonin, immune markers, and alterations in the brain structure and function in patients with depression could identify potential MDD biomarkers.
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Affiliation(s)
- Eunsoo Won
- Department of Psychiatry, Chaum, Seoul 06062, Korea;
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon 21565, Korea;
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea
- Correspondence:
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Tonon AC, Pilz LK, Markus RP, Hidalgo MP, Elisabetsky E. Melatonin and Depression: A Translational Perspective From Animal Models to Clinical Studies. Front Psychiatry 2021; 12:638981. [PMID: 33897495 PMCID: PMC8060443 DOI: 10.3389/fpsyt.2021.638981] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
Daily rhythm of melatonin synchronizes the body to the light/dark environmental cycle. Several hypotheses have been raised to understand the intersections between melatonin and depression, in which changes in rest-activity and sleep patterns are prominent. This review describes key experimental and clinical evidence that link melatonin with the etiopathology and symptomatology of depressive states, its role in the follow up of therapeutic response to antidepressants, as well as the clinical evidence of melatonin as MDD treatment. Melatonin, as an internal temporal cue contributing to circadian organization and best studied in the context of circadian misalignment, is also implicated in neuroplasticity. The monoaminergic systems that underly MDD and melatonin production overlap. In addition, the urinary metabolite 6-sulfatoxymelatonin (aMT6) has been proposed as biomarker for antidepressant responders, by revealing whether the blockage of noradrenaline uptake has taken place within 24 h from the first antidepressant dose. Even though animal models show benefits from melatonin supplementation on depressive-like behavior, clinical evidence is inconsistent vis-à-vis prophylactic or therapeutic benefits of melatonin or melatonin agonists in depression. We argue that the study of melatonin in MDD or other psychiatric disorders must take into account the specificities of melatonin as an integrating molecule, inextricably linked to entrainment, metabolism, immunity, neurotransmission, and cell homeostasis.
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Affiliation(s)
- André C. Tonon
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luísa K. Pilz
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Regina P. Markus
- Laboratório de Cronofarmacologia, Departamento de Fisiologia, Instituto de Biociência, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Elaine Elisabetsky
- Programa de Pós-Graduação em Ciências Biológicas-Bioquímica, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Islam Z, Hu H, Akter S, Kuwahara K, Kochi T, Eguchi M, Kurotani K, Nanri A, Kabe I, Mizoue T. Social jetlag is associated with an increased likelihood of having depressive symptoms among the Japanese working population: the Furukawa Nutrition and Health Study. Sleep 2020; 43:5573922. [PMID: 31555821 PMCID: PMC6985924 DOI: 10.1093/sleep/zsz204] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/11/2019] [Indexed: 12/11/2022] Open
Abstract
STUDY OBJECTIVES Social jetlag, a mismatch between biological and social timing, has been reported to be associated with depressive symptoms among general population. However, evidence on this association is lacking among non-shift workers, who are under pressure to adapt themselves to a work schedule. We investigated the cross-sectional association of social jetlag with depressive symptoms among Japanese non-shift workers. METHODS This study included 1,404 employees, aged 18-78 years, who completed a study questionnaire at a periodic health checkup. Social jetlag was calculated as the absolute value of the difference in the midpoint of sleep times between weekdays and weekends. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Multivariable logistic regression was used to estimate the odds ratio (OR) with adjustments for potential confounders including diet and chronotype. RESULTS Of the study participants, 63.5%, 28.4%, and 8.1% had less than 1 hour, 1 to less than 2 hours, and at least 2 hours of social jetlag, respectively. Greater social jetlag was significantly associated with an increased likelihood of having depressive symptoms. The multivariable-adjusted OR (95% confidence interval) were 1.30 (0.95 to 1.78) and 2.14 (1.26-3.62) for 1 to less than 2 hour and at least 2 hours compared to less than 1 hour of social jetlag. The association between social jetlag and depressive symptoms appeared to be linear, according to restricted cubic spline regression. CONCLUSION Results suggest that greater social jetlag is associated with an increased likelihood of having depressive symptoms among non-shift workers.
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Affiliation(s)
- Zobida Islam
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Huanhuan Hu
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo.,Teikyo University Graduate School of Public Health, Tokyo
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo
| | - Kayo Kurotani
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo.,Department of Nutritional Epidemiology and Shokuiku, Department of Nutritional Education, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Isamu Kabe
- Teikyo University Graduate School of Public Health, Tokyo
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
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Bradley AJ, Dinan TG, Chiang SC, Chen JJ, Chen CH, Sun HJ, Hwu HG, Lai MS. A randomised controlled study of risperidone and olanzapine for schizophrenic patients with neuroleptic-induced acute dystonia or parkinsonism. J Psychopharmacol 2010; 24:91-8. [PMID: 18801830 PMCID: PMC2951595 DOI: 10.1177/0269881108096070] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The objective of this study was to compare the effects of risperidone and olanzapine in schizophrenic patients with intolerant extrapyramidal side effects (EPS) on first generation antipsychotics. We conducted an 8-week, rater-blinded, flexible dose study. Seventy patients with schizophrenia, who met the DSM-IV research criteria of having neuroleptic-induced acute dystonia or parkinsonism, were randomly assigned to risperidone or olanzapine group. The primary outcome was a comparison of the incidence of concomitant anticholinergic drugs usage between the groups to manage their acute dystonia and parkinsonism. The average doses of risperidone and olanzapine from baseline to study end point were 1.8-3.5 mg/day and 7.7-11.7 mg/day, respectively. There were no significant differences in demographic data, severity of EPS or psychotic symptoms between the groups at baseline assessment. Patients taking risperidone had significantly higher incidence of using anticholinergic drugs to manage acute dystonia or parkinsonism overall during the study (OR = 5.17, 95%CI = 1.49-17.88, P = 0.013). There was no significant between-group difference in the changing of rating scales of EPS and psychotic symptoms. The results of our study favour olanzapine as a better choice in schizophrenic patients with intolerant EPS. Double-blinded, fixed dose and different ethnical study for EPS-intolerant schizophrenic patients is needed to confirm the results of our study.
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Affiliation(s)
- Andrew J Bradley
- Eli Lilly and Company Ltd, Basingstoke, UK.,Andrew J Bradley, Eli Lilly and Company Ltd, Lilly House, Priestly Road, Basingstoke, Hampshire RG24 9NL, United Kingdom
| | - Timothy G Dinan
- Department of Psychiatry, Cork University Hospital, Cork, Ireland
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Bradley AJ, Dinan TG. A systematic review of hypothalamic-pituitary-adrenal axis function in schizophrenia: implications for mortality. J Psychopharmacol 2010; 24:91-118. [PMID: 20923924 PMCID: PMC2951595 DOI: 10.1177/1359786810385491] [Citation(s) in RCA: 183] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There is convincing evidence that environmental stress plays a significant role in modifying both mental and physical health. The biological mechanisms linking stress to ill health are not fully understood, but significant evidence points to a central role of the stress axes; the hypothalamic- pituitary-adrenal (HPA) axis and the sympathetic nervous system. Together these two systems link the brain and the body and are crucial in maintaining homeostasis as well as improving an organism's survival chances in the face of environmental challenge. There is evidence of altered HPA axis function in people with a range of mental disorders, and this may in part explain the poor physical health of people with psychotic, mood and anxiety disorders. This paper systematically reviews HPA axis function in people with schizophrenia and relates this to the pattern of physical health seen in this disease. In summary, the evidence suggests people with schizophrenia can experience both hyper- and hypo-function of the HPA axis. It is likely that this contributes to the pattern of poor physical health and premature mortality suffered by people with schizophrenia, in particular the high rates of cardiovascular and metabolic disturbance.
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Affiliation(s)
| | - Timothy G Dinan
- Department of Psychiatry, Cork University Hospital, Cork, Ireland
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Paparrigopoulos T. Melatonin response to atenolol administration in depression: indication of beta-adrenoceptor dysfunction in a subtype of depression. Acta Psychiatr Scand 2002; 106:440-5. [PMID: 12392487 DOI: 10.1034/j.1600-0447.2002.02342.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate peripheral beta-adrenoceptor sensitivity in depression by assessing urinary melatonin pre- and post-administration of atenolol. METHOD Overnight urinary melatonin pre- and post-administration of 100 mg oral atenolol was assessed in 36 depressed subjects and 47 controls. RESULTS Baseline melatonin was significantly lower in depressed patients than controls (P=0.004). Melatonin following atenolol administration was strongly reduced in both groups (P < 0.0001). This reduction depends on whether the subject is a high or low (cutoff: 0.25 nmol/l) baseline melatonin excretor (P=0.025) and on whether he is depressed being a low excretor (P=0.048). A negative correlation (P=0.007) was found between melatonin decrease after atenolol and the Montgomery-Asberg Depression Rating Scale score. CONCLUSION Atenolol strongly reduces melatonin in depressed and control subjects; this decrease relates inversely to the severity of depressive symptoms. Furthermore, responsiveness to atenolol differs between low melatonin depressed patients and low excretor controls, alluding to beta-adrenoceptor up-regulation in a subtype of depression.
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Affiliation(s)
- T Paparrigopoulos
- Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece.
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Paparrigopoulos T, Psarros C, Bergiannaki JD, Varsou E, Dafni U, Stefanis C. Melatonin response to clonidine administration in depression: indication of presynaptic alpha2-adrenoceptor dysfunction. J Affect Disord 2001; 65:307-13. [PMID: 11511411 DOI: 10.1016/s0165-0327(00)00270-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to investigate alpha2-adrenoceptor sensitivity in depression, by using melatonin response to clonidine administration as an index of alpha2-adrenoceptor functioning. METHOD 35 depressed subjects and 41 healthy controls were assessed for overnight urinary melatonin pre- and post-administration of oral clonidine. RESULTS Administration of clonidine significantly reduced melatonin concentrations in depressed patients but not in control subjects. LIMITATION A single oral dose (0.15 mg) of clonidine was administered. CONCLUSIONS Further indication is provided for presynaptic alpha2-adrenoceptor dysfunction in depression with the application of an alternative pharmacological challenge method.
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Affiliation(s)
- T Paparrigopoulos
- Department of Psychiatry, Athens University Medical School, Eginition Hospital, 74 Vas. Sofias Ave., 11528, Athens, Greece.
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Werstiuk ES, Coote M, Griffith L, Shannon H, Steiner M. Effects of electroconvulsive therapy on peripheral adrenoceptors, plasma, noradrenaline, MHPG and cortisol in depressed patients. Br J Psychiatry 1996; 169:758-65. [PMID: 8968635 DOI: 10.1192/bjp.169.6.758] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The mechanism of the antidepressant action of electroconvulsive therapy (ECT) remains unknown. Based on previous work with antidepressant drugs and their effects on the noradrenergic system, we undertook this study to further determine the effects of ECT on selected indices of peripheral adrenoceptor function in depressed patients. METHODS Binding parameters (Bmax and Kd) of platelet alpha 2- and leukocyte beta 2-adrenoceptors, plasma noradrenaline (NA), 3-methoxy-4-hydroxy-phenylglycol (MHPG) and cortisol levels were determined in 18 patients, prior to treatment and 14 days after the last of a series of ECTs, and compared with samples obtained from 18 matched control subjects. RESULTS Platelet alpha 2-adrenoceptor sites were significantly elevated in untreated patients compared with controls (P < 0.03), but leukocyte beta 2-adrenoceptor numbers did not differ. Treatment with ECT led to a significant reduction in platelet alpha 2-adrenoceptor numbers, whereas leukocyte beta 2-adrenoceptor densities increased. Pre-ECT plasma NA, MHPG, and cortisol levels were elevated in patients, compared with controls, and decreased following ECT, but these differences were not statistically significant. Post-ECT plasma NA and beta 2-adrenoceptor numbers were significantly, negatively correlated (P < 0.05). CONCLUSIONS These results suggest that platelet alpha 2-adrenoceptors are supersensitive in depressed patients and treatment with ECT results in down-regulation of these receptors, which may be interpreted as a primary therapeutic, "normalising' effect. The post-ECT changes in leukocyte beta 2-adrenoceptors are probably only secondary to the lower circulating plasma NA levels.
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Affiliation(s)
- E S Werstiuk
- Department of Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
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Kennedy SH, Brown GM. Effect of chronic antidepressant treatment with adinazolam and desipramine on melatonin output. Psychiatry Res 1992; 43:177-85. [PMID: 1410073 DOI: 10.1016/0165-1781(92)90132-m] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Output of melatonin or its main metabolite, 6-sulphatoxy melatonin, provides an index of noradrenergic activity in the pineal gland, which is of interest in major depression and during its treatment with antidepressants. Fifteen female depressed outpatients did not differ in levels of 24-hour urinary 6-sulphatoxy melatonin compared with 13 female control subjects. However, a subgroup of the depressed patients (n = 9) who were treated with desipramine showed a significant elevation of 6-sulphatoxy melatonin levels after 1 week of treatment and a return to baseline levels after 6 weeks. There was also a significant negative correlation between 6-sulphatoxy melatonin levels and symptom severity as measured by the Hamilton Rating Scale for Depression after 3 weeks of treatment with desipramine. The other subgroup of depressed patients (n = 6) were treated with adinazolam, a benzodiazepine with antidepressant properties. Despite comparable antidepressant effects to those achieved with desipramine, adinazolam was not associated with any apparent change in 6-sulphatoxy melatonin output during 6 weeks of treatment. There was also no correlation between 6-sulphatoxy melatonin levels and symptom severity.
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Affiliation(s)
- S H Kennedy
- Eating Disorder Program, Toronto Hospital, Ont., Canada
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