Diurnal profile of melatonin concentrations in patients with major depression: relationship to the clinical manifestation and antidepressant treatment.

OBJECTIVES The aim of the study was to establish if there are differences in the 24-hour melatonin secretion profile between patients with major depression (before, and after treatment with clomipramine) compared to those in healthy subjects. Additionally, we determined if there are differences in melatonin concentrations, depending on the severity of depression, and the presence of 24-hour rhythm disturbances. MATERIAL AND METHODS Twenty patients with major depression and 24-hour rhythm disturbances, and 14 healthy volunteers took part in the study. Before, and after treatment with clomipramine all subjects had blood samples collected at 08:00, 14:00, 20:00, 24:00, 02:00, 04:00, and 08:00 h, for estimation of melatonin concentrations. Before and after treatment, the severity of depression was evaluated using the following scales: the Hamilton Depression Rating Scale (HADRS), Beck Depression Inventory (BDI), and clinical observation, as well as presence, and if so, severity of 24-hour rhythm disturbances were assessed. RESULTS In individuals with major depression with marked disturbances of their diurnal rhythms, melatonin secretion is also disturbed, shown by the higher melatonin concentrations at night as compared to those in healthy individuals. However, melatonin levels were independent of the severity or the clinical manifestation of depression. Moreover, no correlation between the disturbances in their diurnal rhythms (sleep-watchfulness, diurnal mood shifts) and disturbed melatonin pattern was observed. CONCLUSIONS Melatonin nocturnal concentrations in patients with major depression were higher than those in healthy individuals. However, the melatonin concentration values do not differentiate the patients in terms of the severity of the depressive symptoms.