Rosenthal N E, Sack D A, Jacobsen F M, James S P, Parry B L, Arendt J, Tamarkin L, Wehr T A
J Neural Transm Suppl. 1986;21:257-67.
In several studies we have found that treatment with bright environmental light, capable of suppressing human melatonin, reverses the winter depressive symptoms of patients with seasonal affective disorder (SAD), whereas light too dim to suppress human melatonin is therapeutically ineffective. This finding, as well as the central importance of melatonin as a hormonal mediator of photoperiodic changes on seasonal rhythms in animals, led us to test the hypothesis that melatonin mediates the effects of shortening days on the winter symptoms of SAD and that the modification of melatonin secretion by bright light mediates its antidepressant effects. We partially reversed the antidepressant effects of phototherapy in 8 SAD patients by oral melatonin administration, but in another study of 19 SAD patients we failed to find any therapeutic difference between the beta-adrenergic blocker, atenolol, which inhibits melatonin secretion, and placebo. In a third study of 7 SAD patients we showed that the anti-depressant effects of phototherapy were not photoperiodic and appeared to be independent of melatonin suppression. There is some preliminary evidence that melatonin secretion may be abnormal in SAD. We conclude that while melatonin may play some role in the symptoms of SAD and the effects of phototherapy, it cannot by itself account for these phenomena.
在多项研究中，我们发现，用能够抑制人体褪黑素的明亮环境光进行治疗，可逆转季节性情感障碍（SAD）患者的冬季抑郁症状，而亮度太暗以至于无法抑制人体褪黑素的光在治疗上则无效。这一发现，以及褪黑素作为动物季节性节律中光周期变化的激素介质的核心重要性，促使我们去检验这样一个假设：褪黑素介导了白昼缩短对SAD冬季症状的影响，并且明亮光线对褪黑素分泌的调节介导了其抗抑郁作用。我们通过口服褪黑素使8名SAD患者的光疗抗抑郁效果部分逆转，但在另一项针对19名SAD患者的研究中，我们未能发现抑制褪黑素分泌的β-肾上腺素能阻滞剂阿替洛尔与安慰剂之间存在任何治疗差异。在第三项针对7名SAD患者的研究中，我们表明光疗的抗抑郁效果并非光周期的，而且似乎与褪黑素抑制无关。有一些初步证据表明，SAD患者的褪黑素分泌可能异常。我们得出结论，虽然褪黑素可能在SAD症状及光疗效果中发挥一定作用，但它本身无法解释这些现象。
