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    Major Depression

    Major Depression Syndrome -- which is characterized by depressed mood and loss of interest in addition to other symptoms such as weight gain or loss, poor sleep patterns and fatigue -- has been associated with decline of norepinephrine (Schildkraut, 1965). The decrease of norepinephrine would lead to a decrease in stimulus for melatonin synthesis and release. Early studies support this view (Beck-Friis, et al., 1985; Claustrat, et al., 1984; Wetterberg, et al., 1979, 1982). Wetterberg, et al., also reported decreased melatonin levels at night in depressed patients with abnormal dexamethasone suppression test (DST).

    They also reported a higher hereditary factor for major depression among relatives with low nocturnal melatonin. Wetterberg even suggests that low nocturnal melatonin level may serve as a marker for depression.

    The problem that may arise with the above studies was that the controls and patients were not well matched, and many of the patients were on medications that may have influenced the levels of melatonin.

    Subsequent studies by Thomson, et al., and Rubin, et al., studied depressed patients without medications and with a proper control group. They found no difference in melatonin levels between depressed patients and the well matched controls.

    Several studies on manic depressive patients revealed that during depressive episodes there was no difference in melatonin levels. However, during manic episodes a twofold increase of nocturnal melatonin was observed (Kennedy, et al., 1989; Kivela, et al., 1989; and Wirz-Justice, et al., 1980).

    At present there are no consistent findings that prove a relationship between melatonin and depression. However, most researchers believe that nocturnal melatonin is low in depressed patients.



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