MHPG Excretion by Patients with Affective Disorders

The evidence which suggests that urinary 3-methoxy-4-hydroxyphenethylene glycol (MHPG) may reflect the disposition of norepinephrine (NE) within the brain is briefly reviewed, and studies from different research groups indicating that some depressed patients excrete less than normal quantities of MHPG are noted. Data which indicates that those depressed patients who excrete less than normal amounts of MHPG can be identified by explicit clinical criteria as well as by a favorable treatment response to imipramine are summarized. These findings, as well as others which are noted in this paper, lead us to conclude that there is an identifiable group of depressed patients who have a disorder of NE metabolism and/or disposition which is integral to the illness per se.