Rabe-Jabłońska J, Szymańska A
Department of Psychiatry, 2nd Psychiatric Clinic, Medical University, Lodz, Poland.
Med Sci Monit. 2001 Sep-Oct;7(5):946-52.
The aim of this study was to determine whether there are differences in the 24-hour melatonin secretion profile between patients with major depression (MD) before and after clomipramine treatment, and a control group, and also whether or not there exist statistically significant differences in the melatonin levels depending on the severity of depression.
20 patients with MD and 14 healthy volunteers took part in the study. Before and after clomipramine treatment all the patients had an 8 ml blood sample collected 7 times, at fixed hours, for measurement of the melatonin level. The severity of depression was assessed (HAMDS, BDI, POMS) before and after treatment.
The mean melatonin concentration at each of the chosen hours was higher in persons with MD than in the control, but the differences reached statistical significance only at certain night hours. In both groups the nocturnal rise in melatonin secretion began at 12 midnight, reaching its peak at 2 am, to reach low values by 8 am, similar to the values from the previous morning. After 8 weeks of clomipramine treatment, the melatonin concentrations at 12 midnight, 2 am, and 4 am were lowered, and were elevated at 8 am, 2 pm, and 8 pm. The difference was statistically significant only at 8 pm. Melatonin secretion during both night time hours and daytime hours is higher in individuals with MD than in healthy subjects, and remains elevated after 8 weeks of effective clomipramine treatment. Those patients whose state changed the least after 8 weeks of clomipramine treatment differed in a statistically significant way in terms of melatonin secretion level at 2 pm from those patients who improved the most.
Some patients with MD have elevated melatonin concentration levels during daytime and nighttime hours, and this melatonin secretion pattern is independent of the severity of depression.
本研究的目的是确定重度抑郁症（MD）患者在氯米帕明治疗前后与对照组之间24小时褪黑素分泌情况是否存在差异，以及褪黑素水平是否因抑郁症严重程度而存在统计学上的显著差异。
20例MD患者和14名健康志愿者参与了本研究。在氯米帕明治疗前后，所有患者均在固定时间采集7次8毫升血样，用于测量褪黑素水平。在治疗前后评估抑郁症的严重程度（采用汉密尔顿抑郁量表、贝克抑郁量表、情绪状态量表）。
MD患者在每个选定时间点的平均褪黑素浓度均高于对照组，但差异仅在特定夜间时间点达到统计学显著水平。两组中褪黑素分泌的夜间升高均始于午夜12点，在凌晨2点达到峰值，到上午8点降至低值，与前一天上午的值相似。氯米帕明治疗8周后，午夜12点、凌晨2点和凌晨4点的褪黑素浓度降低，而上午8点、下午2点和晚上8点升高。差异仅在晚上8点具有统计学显著性。MD患者在夜间和白天的褪黑素分泌均高于健康受试者，且在氯米帕明有效治疗8周后仍保持升高。在氯米帕明治疗8周后状态变化最小的患者与改善最大的患者相比，下午2点时的褪黑素分泌水平在统计学上有显著差异。
一些MD患者在白天和夜间的褪黑素浓度水平升高，且这种褪黑素分泌模式与抑郁症严重程度无关。
