The Tyramine Conjugation Test in Unipolar and Bipolar Depressed Patients: Utility as a Predictor of Treatment Response
Over the last 12 years, evidence has accumulated that depressed patients show abnormal metabolism of orally-administered loads of tyramine, excreting significantly less tyramine-0-sulphate than normal controls (Sandler et al., 1975; Harrison et al., 1984; Hale et al., 1986). These studies have demonstrated that the abnormality is present only in that group of patients on whom the presence of characteristic biological symptoms and signs confer the label, endogenous depression. Patients without these features (variously labelled neurotic, non-endogenous, atypical, mood-reactive, minor) have a tyramine response to oral challenge indistinguishable from that of normal controls. Such tyramine excretion appears to be independent of severity of illness, age and sex. The abnormality persists after recovery from an episode of illness (Bonham Carter et al., 1978; Harrison et al., 1984) and is present in non-affected first degree relatives of patients (Hale et al., 1986). It may thus represent a trait marker for endogenous depression.
KeywordsMajor Depressive Disorder Bipolar Patient Oral Challenge Research Diagnostic Criterion Trait Marker
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