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Pharmacopsychiatry 2002; 35(5): 175-181
DOI: 10.1055/s-2002-34116
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Plasma Levels of Catecholamine Metabolites Predict the Response to Sulpiride or Fluvoxamine in Major Depression

N. Ueda1 , R. Yoshimura1 , K. Shinkai1 , J. Nakamura1
  • 1Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
The present study was partly supported by a Research Grant for Nervous and Mental Disorders from the Ministry and Welfare, Japan
Further Information

Publication History

Received: 27. 4. 2001 Revised: 22. 11. 2001

Accepted: 14. 1. 2002

Publication Date:
18 September 2002 (online)

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We investigated the relationships between the changes in plasma catecholamine metabolites obtained from depressed patients before and after administration of sulpiride, a benzamide compound, or fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), and between clinical responses to treatment with each of these drugs. Responders to sulpiride had significantly lower plasma homovanillic acid (pHVA) levels before administration of sulpiride than did non-responders or controls (responders: 4.5 ± 3.1 ng/ml, non-responders: 11.1 ± 5.9 ng/ml, controls: 10.9 ± 5.3 ng/ml). Positive relationships were observed between changes in pHVA levels and improvement rates in the 17-item Hamilton Depression Rating Scale (Ham-D). In contrast, responders to fluvoxamine had significantly higher plasma free 3-methoxy-4-hydroxyphenylglycol (pMHPG) levels before administration of fluvoxamine than did non-responders or controls (responders: 8.5 ± 1.8 ng/ml, non-responders: 5.9 ± 2.I ng/ml, controls: 5.2 ± 2.9 ng/ml). Negative relationships were observed between changes in pMHPG levels and improvement rates in Ham-D. These results suggest that lower pretreatment pHVA levels and higher pretreatment levels of pMHPG might be predictors of response to sulpiride and fluvoxamine, respectively, and that sulpiride might produce a functional increase in the dopaminergic system, resulting in improvement in some depressive symptoms; fluvoxamine, on the other hand, might produce a functional decrease in the noradrenergic system via serotonergic neurons, resulting in improvement of those symptoms.

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Nobuhisa Ueda

Department of Psychiatry

School of Medicine

University of Occupational and Environmental Health

1-1 Iseigaoka

Yahatanisi-ku

Kitakyusyu, 807-8555

Fukuoka

Japan

Phone: +81 (93) 691-7253

Fax: +81 (93) 692-4894

Email: EZD04735@nifty.com