[Clinical, biochemical and psychopharmacologic correlates in patients with depressive symptomatology]

A population of 41 clinic outpatients suffering depressive symptomatology was studied. According to the presence or absense of sixteen specific symptoms it was possible to distribute these patients in three different groups. Simultaneously urinary determinations of phenethylamine (PEA), 3-methoxy-4-hydroxyphenylethylglicol (MHPG), phenylacetic acid, 5-hydroxyindolacetic acid and serum 5-hydroxytriptamine were performed. A clossed clinical-biochemical correlation was noted in each group in relation to PEA and MHPG daily output. The other determinated values were not significant. Besides the clinical data, the mentioned groups presented the following characteristic output data: group A: decreased PEA and MHPG levels, group B, decreased PEA and normal MHPG levels and group C: normal values of the two substances. Five tricyclic antidepressant drugs were tested in the three groups. It was shown that patients with low pretreatment urinary output values of PEA and MHPG responded favourably to imipramine, desipramine and nortriptyline, alone or in association. On the other side, the group B responded favourably to chlorimipramine and amitriptiline, alone or in combination. No change or clinically worse were observed in patients of these groups when medication was not administrated according to the described form. The group with normal PEA and MHPG output values worsened or did not respond to medication following administration of any of the antidepressants essayed. Only psychotherapeutic treatment in combination with ansiolitics let to an improvement of symptomatology. At least, our findings suggest a closed clinical-biochemical-psychopharmacological correlate of some classes of depression that may provide rational basis for a more predictive tricyclic antidepressant therapy.