David N. Anderson

The role of pterins in depression and the effects of antidepressive therapy.

Urinary excretion of neopterins (N) and biopterins (B) was measured in 48 patients with depression before and after treatment with placebo, antidepressants, or electroconvulsive therapy (ECT), and in 26 healthy control subjects. Patients prior to and after treatment had a significantly greater neopterin/biopterin (N:B) ratio than control subjects. There was a significant correlation between N:B ratios and the severity of depression and plasma cortisol. As a raised N:B ratio implies failure to convert neopterin to biopterin, it is possible that reduced availability of tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, serotonin and dopamine, may exert rate-limiting control over the synthesis of monoamines implicated in the pathogenesis of depressive illness.

Does age predict the long-term outcome of depression treated with ECT? (a prospective study of the long-term outcome of ECT-treated depression with respect to age).

Sixty‐three subjects with DSM‐III‐R major depression with melancholia or psychosis were followed up 2–4 years after index treatment with electroconvulsive therapy. There was a twofold increase in likelihood of improved outcome with an additional 20 years of age.