T. A. Ramsey

Biogenic amine metabolites in cerebrospinal fluid of depressed and manic patients.

A reduction in 5-hydroxyindoleacetic acid in cerebrospinal fluid was found in depressed and manic patients both while they were symptomatic and also after treatment. The concentration of homovanillic acid was initially reduced and then tended to increase after treatment.

Plasma and Erythrocyte Cations in Affective Illness

Plasma and erythrocyte cations (sodium and magnesium) were studied in groups of patients with an affective disorder and in normal subjects. Baseline determinations were obtained before initiation of treatment for mania or depression. In a subgroup of patients, sequential measurements of cations were made during treatment with lithium carbonate. No differences were found in intraerythrocyte sodium or magnesium among any of the patient groups and controls. Patients with a primary affective disorder had significantly higher plasma sodium than control subjects. Neither baseline cation concentrations nor changes in cation concentration during treatment with lithium correlated with treatment response. Gender was shown to be a significant variable affecting intraerythrocyte cation concentrations.

Red blood cell Li+ to plasma Li+ ratios. Are they related to plasma Li+ concentrations?

The relationship between the lithium ratio (ratio of lithium in blood cells to that in plasma) and plasma lithium concentration was examined in a group of male inpatients taking lithium carbonate for affective disorders. The lithium ratio was found to increase in the majority of these patients as plasma lithium concentration increased. However, the magnitude of variation of the lithium ratio with plasma lithium concentration observed in these patients is not sufficient to seriously affect the value of determining the lithium ratio in the clinical situation.

MMPI Prediction of Imipramine Response: a Replication Study

18 hospitalized male depressives were treated with imipramine hydrochloride for 28 days. Prior to initiating treatment, each patient completed the Minnesota Multiphasic Personality Inventory (MMPI). At the end of the treatment period, the patients were divided into groups of responders and nonresponders based on the change in their Hamilton Depression Rating Scale scores. The Imipramine Response Scale - Male (IRS-M) was scored for each patient and the ability of the scale to predict response or nonresponse in our sample of patients was examined. There was no evidence that the IRS-M was better than chance in its ability to predict response.

STUDIES OF SODIUM, MAGNESIUM AND LITHIUM IN PATIENTS WITH AFFECTIVE ILLNESS

Alterations in cation concentration, transport or distribution play an important role in the regulation of neuronal function and may contribute to the production of abnormal mood states such as depression or mania. The effectiveness of the cation, lithium, in the treatment of affective disorders has spurred increased interest in and investigation into cation metabolism in these illnesses. The findings from investigations of sodium, magnesium and lithium are reviewed and the idea is advanced that the erythrocyte can be used as a model for the neuronal transport and concentration of these cations. Evidence is presented that the intraerythrocyte lithium concentration, as expressed by the Lithium Ratio, is significantly different between unipolar and bipolar groups of patients. Intraerythrocyte sodium and magnesium do not appear to differ between diagnostic groups or between manic and depressed patients and controls. However, sex is an important variable affecting the concentrations of all three of these cations and this factor must be taken into account in future studies of cation metabolism in affective disorders.