The acute effects of starvation on 6-sulphatoxy-melatonin output in subgroups of patients with anorexia nervosa

Sequential measures of daytime and nighttime sulphatoxy-melatonin (aMT6s) in 10 female patients with anorexia nervosa (AN) and 12 female patients with concurrent AN with bulimic symptoms (AN + BN) were compared with 13 female control subjects. The AN + BN group displayed a significant increase in aMT6s output in the acutely symptomatic state compared with both AN patients and controls. However, there were no subsequent differences after 7 or 14 days between the two patient groups. The AN + BN group also initially demonstrated a significant increase in daytime output of aMT6s compared to nighttime with a trend toward reversing this pattern after 7 and 14 days. Altered melatonin output may influence the course of illness or reflect greater disruption of circadian rhythm in those anorexic patients who also binge and purge compared to restricting anorexics.