The Study Of The Metabolite Products Of Monoamine Neurotransmitters In Treatment-Resistant Depression Patients Before And After Therapy

Objective: The study aims to discuss plasma metabolite change of monoamine neurotransmitters in patients with Treatment-Resistant depression (TRD) before and after therapy.Methods: Altogether 30 TRD patients (That is, currently, Although two or more different types of antidepressants were used, it is still consistent with the diagnostic criteria for depressive episode), who met the diagnostic criteria of depression in China Criteria Manual Diagnostic third edition (CCMD-3) and 30 non TRD patients who met the diagnostic criteria of depression in China Criteria Manual Diagnostic third edition (CCMD-3) were included in this study. The mean age of TRD patients was 46.53±11.45 years old and the mean age of non TRD patients was 42.73±15.94 years old. The patients were recruited and assessed by using Hamilton Depression Scale (HAMD) before treatment and after treatment 4 weeks,6 weeks,8 weeks. Plasma metabolite products of monoamine neurotransmitters (5-HIAA,MHPG,HVA) were evaluated by using ELISA method in 30 TRD patients and 30 non TRD patients. Statistic methods such as t test, repeated measures, correlation analysis were used to analyze the data.Results: 1. The serous levels of 5-HIAA, MHPG and HVA before therapy in the TRD group were lower than those in the non TRD group (p<0.01), the serous level of HAMD before therapy in the TRD group were higher than those in the non TRD group (p<0.01).2. The serous levels of 5-HIAA, MHPG and HVA after therapy 4 weeks,6 weeks,8 weeks in the TRD group were lower than those in the non TRD group (p<0.01), the serous level of HAMD before therapy in the TRD group were higher than those in the non TRD group (p<0.05).3. The serous levels of 5-HIAA, MHPG were increased after therapy compared with the levers before therapy in the TRD group (p<0.001), the serous level of HAMD was decreased after therapy compared with the lever before therapy in the TRD group (p<0.001). But HVA level had no significant change (p>0.05).4. The serous levels of 5-HIAA, MHPG were increased after therapy compared with the levers before therapy in the non TRD group (p<0.001), the serous level of HAMD was decreased after therapy compared with the lever before therapy in the non TRD group (p<0.001). But HVA level had no significant change (p>0.05).5. In the TRD group, the levels of 5-HIAA, MHPG and HVA had no significantly associated with severity of depression (p>0.05).6. In the non TRD group, the levels of 5-HIAA, MHPG and HVA had no significantly associated with severity of depression (p>0.05).7. In the TRD group, the levels of 5-HIAA, MHPG and HVA didn't have significant correlation (p>0.05).8. In the non TRD group, the levels of 5-HIAA, MHPG and HVA didn't have significant correlation (p>0.05).Conclusions: 1. The levels of plasma metabolite products of monoamine neurotransmitters in the TRD patients were lower than those in the non TRD patients and the function of monoamine neurotransmitters need to be researched in the future;2. Individual rational use of SNRI drugs combined with psychological treatment can improve peripheral levels of monoamine neurotransmitters and reduce depression in TRD patients.