RESUMO
Urinary excretion of neopterins (N) and biopterins (B) was measured in 48 patients with depression before and after treatment with placebo, antidepressants, or electroconvulsive therapy (ECT), and in 26 healthy control subjects. Patients prior to and after treatment had a significantly greater neopterin/biopterin (N:B) ratio than control subjects. There was a significant correlation between N:B ratios and the severity of depression and plasma cortisol. As a raised N:B ratio implies failure to convert neopterin to biopterin, it is possible that reduced availability of tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, serotonin and dopamine, may exert rate-limiting control over the synthesis of monoamines implicated in the pathogenesis of depressive illness.
Assuntos
Antidepressivos/uso terapêutico , Biopterinas/análogos & derivados , Biopterinas/urina , Transtorno Depressivo/terapia , Eletroconvulsoterapia , Adulto , Idoso , Amitriptilina/efeitos adversos , Amitriptilina/uso terapêutico , Antidepressivos/efeitos adversos , Ensaios Clínicos como Assunto , Transtorno Depressivo/psicologia , Transtorno Depressivo/urina , Feminino , Humanos , Hidrocortisona/sangue , Masculino , Pessoa de Meia-Idade , Neopterina , Piperoxano/efeitos adversos , Piperoxano/análogos & derivados , Piperoxano/uso terapêutico , Pirróis/efeitos adversos , Pirróis/uso terapêutico , Pirrolidinonas/efeitos adversos , Pirrolidinonas/uso terapêutico , Valores de Referência , RolipramRESUMO
Urinary excretion of neopterins and biopterins was measured in 23 patients with severe depression before and after receiving electroconvulsive therapy (ECT) and 26 healthy control subjects. Patients with psychotic depression and those responding to ECT had neopterin:biopterin (N:B) ratio significantly higher than controls before commencing ECT and positive therapeutic response was associated with reduction of N:B ratio towards control values. As a raised N:B ratio implies failure to convert neopterin to biopterin it is possible that reduced availability of tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, serotonin and dopamine, may exert rate limiting control over the synthesis of monoamines implicated in the pathogenesis of depressive disorders. The N:B ratio may be a marker for certain depressive subtypes and response to ECT.