Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T09:18:28.811Z Has data issue: false hasContentIssue false

Reduced Central Serotonergic Activity in Mania: Implications for the Relationship between Depression and Mania

Published online by Cambridge University Press:  29 January 2018

J. Mendels
Affiliation:
Veterans Administration Hospital, Philadelphia, Pa. 19104, U.S.A.
A. Frazer
Affiliation:
Veterans Administration Hospital, Philadelphia, Pa. 19104, U.S.A.

Extract

For the past decade there has been extensive interest in the hypothesized association between brain amine function and disturbances in mood (either depression or mania). The more influential theories have postulated that clinical depression is associated with a decrease in aminergic function (either norepinephrine, dopamine or serotonin) while mania is associated with increased activity of these amines. This essentially ‘bipolar’ approach has tended to dominate most studies in this area. Evidence supporting these theories has been extensively reviewed (11, 61, 70) and need not be detailed here.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1975 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akimoto, H., Nakakaki, M. & Machiyama, Y. (1960) Clinical experience with MAO inhibitors (a comparison with tofranil). Diseases of the Nervous System, 21, 645–8.Google Scholar
Ashcroft, G. W. & Sharman, D. F. (1962) Drug-induced changes in the concentration of 5-OR indolyl compounds in cerebrospinal fluid and caudate nucleus. British Journal of Psychiatry, 19, 153–60.Google Scholar
Ashcroft, G. W. Crawford, T. B. B., Eccleston, D., Sharman, D. F., MacDougall, E. J., Stanton, J. B. & Binns, J. K. (1966) 5-hydroxyindole compounds in the cerebrospinal fluid of patients with psychiatric or neurological disease. Lancet, ii, 1049–52.Google Scholar
Barchas, J. & Usdin, E. (1973) Serotonin and Behavior. New York: Academic Press.Google Scholar
Bowers, M. P., Heninger, G. R. & Gerbode, F. (1969) Cerebrospinal fluid 5-hydroxyindoleacetic acid and homovanillic acid in psychiatric patients. International Journal of Neuropharmacology, 8, 255–62.Google Scholar
Bulat, M. & Zivkovic, B. (1971) Origin of 5-hydroxyindoleacetic acid in the spinal fluid. Science, 173, 738–40.CrossRefGoogle Scholar
Carpenter, W. T. (1970) Serotonin now: clinical implications of inhibiting its synthesis with para-chlorophenylalanine. Annals of Internal Medicine, 73, 607–29.Google Scholar
Carroll, B. J. (1972) In Depressive Illness: Some Research Studies (eds. Davies, B. M., Carroll, B. J. & Mowbray, R. M.). Springfield: Charles C. Thomas.Google Scholar
Carroll, B. J. Mowbray, R. M. & Davies, B. M. (1970) Sequential comparison of L-tryptophan with E.C.T. in severe depression. Lancet, i, 967–9.Google Scholar
Chernik, D. A. & Mendels, J. (1972) The sleep of the manic. In Sleep Research (eds. Chase, M. H., Stern, W. C. & Walter, P. L.). Los Angeles: Brain Information Service.Google Scholar
Coppen, A. (1967) The biochemistry of affective disorders. British Journal of Psychiatry, 113, 1237–64.Google Scholar
Coppen, A., Brooksbank, B. W. L. & Peet, M. (1972). Tryptophan concentration in the cerebrospinal fluid of depressive patients. Lancet, i, 1393.Google Scholar
Coppen, A., Prange, A. J. Jr. & Whybrow, P. C. (1969) Methysergide in mania. A controlled study. Lancet, ii, 338–40.Google Scholar
Coppen, A., Prange, A. J. Jr., Whybrow, P. C. & Noguera, R. (1972) Abnormalities of indoleamines in affective disorders. Archives of General Psychiatry, 26, 474–8.Google Scholar
Coppen, A., Shaw, D. M. & Farrell, J. P. (1963) Potentiation of the antidepressive effect of a monoamine-oxidase inhibitor by tryptophan. Lancet, i, 7981.Google Scholar
Coppen, A., Shaw, D. M. Herzberg, B. & Maogs, R. (1967) Tryptophan in the treatment of depression. Lancet, ii, 1178–80.Google Scholar
Court, J. H. & Mai, F. M. (1970) A double-blind intensive crossover design trial of methysergide in mania. Medical Journal of Australia, ii, 526–9.Google Scholar
Cremata, V. Y. Jr. & Koe, B. K. (1966) Clinical-pharmacological evaluation of p-chlorophenyl-alanine: a new serotonin-depleting agent. Clinical Pharmacology and Therapeutics, 7, 768–76.Google Scholar
Curzon, G., Gumpert, E. J. & Sharpe, D. M. (1971) Amine metabolites in the lumbar cerebrospinal fluid of humans with restricted flow of cerebrospinal fluid. Nature (New Biology), 231, 189–91.Google Scholar
Dencker, S. J., Malm, U., Roos, B. E. & Werdinius, B. (1966) Acid monoamine metabolites of cerebrospinal fluid in mental depression and mania. Journal of Neurochemistry, 13, 1545–8.Google Scholar
Dewhurst, W. G. (1968) Methysergide in mania. Nature, 219, 506507.Google Scholar
Dyson, W. L. & Mendels, J. (1968) Lithium and depression. Current Therapeutic Research, 10, 601608.Google Scholar
Eccleston, D., Ashcroft, G. W., Moir, A. T. B., Parker-Rhodes, A., Lutz, W. & O'Mahoney, D. P. (1968) A comparison of 5-hydroxyindoles in various regions of dog brain and cerebrospinal fluid. Journal of Neurochemistry, 15, 947–57.CrossRefGoogle ScholarPubMed
Eccleston, D., Ashcroft, G. W., Crawford, T. B. B., Stanton, J. B., Wood, D. & McTurk, P. H. (1970) Effect of tryptophan administration on 5HIAA in cerebrospinal fluid in man. Journal of Neurology, Neurosurgery and Psychiatry, 33, 269–72.Google Scholar
Engelman, K., Lovenberg, W. & Sjoerdsma, A. (1967) Inhibition of serotonin synthesis by p-chlorophenylalanine in carcinoid syndrome. New England Journal of Medicine, 277, 11031108.Google Scholar
Ferguson, J., Henriksen, S., Cohen, H., Mitchell, G., Barchas, J. & Dement, W. (1970) Hypersexuality and behavioral changes in cats caused by administration of p-chlorophenylalanine. Science, 168, 499501.CrossRefGoogle ScholarPubMed
Fernstrom, J. D. & Wurtman, R.J. (1971) Physiological dependence on plasma tryoptophan levels. Science, 173, 149–52.Google Scholar
Fernstrom, J. D. & Wurtman, R.J. (1973) Control of brain 5-HT content by dietary carbohydrates. In Serotonin and Behavior (eds. Barchas, J. and Usdin, E.). New York: Academic Press.Google Scholar
Fieve, R. R., Platman, S. R. & Fliess, J. L. (1969) A clinical trial of methysergide and lithium in mania. Psychopharmacologia, 15, 425–9.Google Scholar
Glassman, A. H. & Platman, S. R. (1969) Potentiation of monoamine oxidase inhibitor by tryptophan. Journal of Psychiatric Research, 7, 83–8.Google Scholar
Goodwin, F. K., Murphy, D. L. & Bunney, W. E. Jr., (1969) Lithium carbonate treatment in depression and mania. A longitudinal double-blind study. Archives of General Psychiatry, 21, 482–96.Google Scholar
Goodwin, F. K., Post, R. M., Dunner, D. L. & Gordon, E. K. (1973) Cerebrospinal fluid amine metabolites in affective illness. The probenecid technique. American Journal of Psychiatry, 130, 73–9.Google Scholar
Griffiths, W. J., Lester, B. K., Coulter, J. D. & Williams, H. L. (1972) Tryptophan and sleep in young adults. Psychophysiology, 9, 345–56.Google Scholar
Guldberg, H. C. & Yates, C. M. (1969) Effects of chlorpromazine on the metabolism of catecholamines in dog brain. British Journal of Pharmacology, 36, 535–48.CrossRefGoogle Scholar
Guldberg, H. C. Ashcroft, G. W. & Crawford, T. B. B. (1966) Concentrations of 5-hydroxyindoleacetic acid and homovanillic acid in the cerebrospinal fluid of the dog before and during treatment with probenecid. Life Sciences, 5, 1571–5.Google Scholar
Gutierrez, J. L. A. & Lopez-Ibor Alino, J. J. (1971) Tryptophan and MAOI (Nialamide) in the treatment of depression. International Pharmacopsychiatry, 6, 92–7.Google Scholar
Gyermek, L. (1966) The pharmacology of imipramine and related antidepressants. International Review of Neurobiology, 9, 95143.Google Scholar
Hartmann, E., Chung, R. & Chien, C.-P. (1971) L-tryptophan and sleep. Psychopharmacologia (Berlin), 19, 114–27.Google Scholar
Haskovec, L. & Soucek, K. (1968) Trial of methysergide in mania. Nature, 219, 507508.Google Scholar
Jouvet, M (1973) Serotonin and sleep in the cat. In Serotonin and Behavior (eds. Barchas, & Usdin, ). New York: Academic Press.Google Scholar
Karli, P., Vergnes, M. & Didiergeorges, F. (1969) Rat-mouse interspecific aggressive behavior and its manipulation by brain ablation and brain stimulation. In Aggressive Behavior (eds. Garattini, & Sigg, ). New York: Wiley.Google Scholar
Kerry, R.J. & Owen, G. (1970) Lithium carbonate as a mood and a total body water stabilizer. Archives of General Psychiatry, 22, 301303.Google Scholar
Kety, S. (1971) Brain amines and affective disorders. In Brain Chemistry and Mental Disease (eds. Ho, & McIsaac, ). New York: Plenum Press.Google Scholar
Klerman, G. L. & Cole, J. O. (1965) Clinical pharmacology of imipramine and related anti-depressant compounds. Pharmacological Review, 17, 101–41.Google Scholar
Koella, W. P., Feldstein, A. & Czicman, J. S. (1968) The effect of parachlorophenylalanine on the sleep of cats. Electroencephalography and Clinical Neurophysiology, 25, 481–90.Google Scholar
Korf, J. (1969) The determination of 5-hydroxytryptamine in human urine. Clinica Chimica Acta, 23, 483–7.Google Scholar
Korf, J. & van Praag, H. M. (1971) Amine metabolism in human brain: further evaluation of the probenecid test. Brain Research, 35, 221–30.Google Scholar
Kotin, J. & Goodwin, F. K. (1972) Depression during mania: clinical observations and theoretical implications. American Journal of Psychiatry, 129, 379–86.CrossRefGoogle ScholarPubMed
Lapin, I. P. & Oxenkrug, G. F. (1969) Intensification of the central serotoninergic processes as a possible determinant of the thymoleptic effect. Lancet, i, 132–6.Google Scholar
Mangoni, A., Andrioli, V., Cabibbe, F. & Mandell, V. (1970) Body fluid distribution in manic and depressed patients treated with lithium carbonate. Acta Psychiatrica Scandinavica, 46, 244–57.Google Scholar
McCabe, M. S., Reich, T. & Winokur, G. (1970) Methysergide as a treatment for mania. American Journal of Psychiatry, 127, 354–56.Google Scholar
Meek, J. L. & Neff, N. H. (1973) Is cerebrospinal fluid the major avenue for the removal of 5-hydroxyindoleacetic acid from the brain? Neuropharmacology, 12, 497–9.Google Scholar
Mendels, J. (1970) Concepts of Depression. New York.Google Scholar
Mendels, J. (1971) Relationship between depression and mania. Lancet, i, 342.Google Scholar
Mendels, J. (1973) Lithium and depression. In Lithium: Its Role in Psychiatric Research and Treatment (eds. Gershon, & Shopsin, ). New York: Plenum Press.Google Scholar
Mendels, J. & Chernik, D. A. (1972) The effect of L-tryptophan on sleep in man. In Sleep Research (eds. Chase, , Stern, & Walter, ). Los Angeles.Google Scholar
Mendels, J. & Fitzgerald, R. G. (1974, in preparation) The coexistance of mania and depression.Google Scholar
Mendels, J. & Frazer, A. (1974) Brain biogenic amine depletion and mood. Archives of General Psychiatry 30, 447–51.Google Scholar
Mendels, J. & Hawkins, D. R. (1971) Longitudinal sleep study in hypomania. Archives of General Psychiatry, 25, 274–7.Google Scholar
Mendels, J. & Hawkins, D. R. (1971) Sleep and depression. IV. Longitudinal studies. Journal of Nervous and Mental Disease, 153, 251–72.CrossRefGoogle ScholarPubMed
Mendels, J. & Stinnett, J. L. (1973) Biogenic amine metabolism, depression and mania. In Biological Psychiatry (ed. Mendels, ). New York: Wiley.Google Scholar
Mendels, J. Fitzgerlad, R. G. & Ramsey, T. A. Unpublished observations.Google Scholar
Mendels, J. Frazer, A., Fitzgerald, R. G., Ramsey, T. A., & Stokes, J. W. (1972) Biogenic amine metabolites in the cerebrospinal fluid of depressed and manic patients. Science, 175, 1380–82.Google Scholar
Mendels, J. Secunda, S. K. & Dyson, W. L. (1972) A controlled study of the antidepressant effects of lithium. Archives of General Psychiatry, 26, 154–57.Google Scholar
Mendels, J. Stinnett, J. L. & Burns, D. D. (1974, in preparation) A controlled study of the use of L-DOPA and L-tryptophan in the treatment of depression.Google Scholar
Moir, A. T. B., Ashcroft, G. W., Crawford, T. B. B., Eccleston, D. & Guldberg, H. C. (1970) Cerebral metabolites in cerebrospinal fluid as a biochemical approach to the brain. Brain, 93, 357–68.Google Scholar
Mouret, J., Bobillier, P. & Jouvet, M. (1068) Insomnia following para-chlorophenylalanine in the rat. European Journal of Pharmacology, 5, 1722.Google Scholar
Murphy, D. L., Baker, M., Kotin, J. & Bunney, W. E. Jr., (1973) Behavioral and metabolic effects of L-tryptophan in unipolar depressed patients. In Serotonin and Behavior (eds. Barchas, & Usdin, ). New York: Academic Press.Google Scholar
Pare, C. M. D. (1963) Potentiation of monoamine-oxidase inhibitors by tryptophan. Lancet, ii, 527–8.Google Scholar
Prange, A. J. Jr., (1964) The pharmacology and biochemistry of depression. Diseases of the Nervous System, 25, 217–21.Google Scholar
Prien, R. F., Caffey, E. M. & Klett, C.J. (1972) Comparison of lithium carbonate and chloro-promazine in the treatment of mania. Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group. Archives of General Psychiatry, 26, 146–53.Google Scholar
Pujol, J. F., Buguet, A., Froment, J. L., Jones, B. & Jouvet, M. (1971) The central metabolism of serotonin in the cat during insomnia. A neuro-physiological and biochemical study after administration of p-chlorophenylalanine or distribution of the Raphe system. Brain Research, 29, 195212.Google Scholar
Rome, H. P. & Braceland, F.J. (1952) Psychological response to corticotropin, cortisone, and related steroid substances, psychotic reaction types. Journal of the American Medical Association, 148, 2730.Google Scholar
Roos, B.-E. & Sjöström, R. (1969) 5-hydroxyindole-acetic acid and homvanillic acid levels in the cerebrospinal fluid after probenecid application in patients with manic-depressive psychosis. Pharmacologia Clinica, 1, 153–5.Google Scholar
Schou, M. (1968) Lithium in psychiatric therapy and prophylaxis. Journal of Psychiatric Research, 6, 6795.Google Scholar
Sheard, M. H. (1970) Behavioral effects of p-chlorophenylalanine in rats: inhibition by lithium. Publications in Behavioral Biology, 5, 71–3.Google Scholar
Shillito, E. (1970) The effect of parachlorophenyl-alanine on social interaction of male rats. British Journal of Pharmacology, 38, 305–15.Google Scholar
Sicuteri, F., Anselmi, B. & Fanciullacci, M. (1970) A therapeutic trial in migraine with para-chlorophenylalanine, a specific serotonin depletion. Headache, 10, 124–5.Google Scholar
Stefanini, M., Roy, C. A., Zannus, L. & Dameshek, W. (1950) Therapeutic effect of pituitary adrenocorticotropic hormone (ACTH) in case of Henoch-Schönlein vascular (anaphylactoid) purpura. Journal of the American Medical Association, 144, 1372–4.Google Scholar
Tagliamonte, A., Tagliamonte, P., Gessa, G. L. & Brodie, B. B. (1969) Compulsive sexual activity induced by p-chlorophenylalanine in normal and pinealectomized male rats. Science, 166, 433–5.Google Scholar
Tagliamonte, A., Tagliamonte, P., Perez-Cruet, J. & Gessa, G. L. (1970) Cerebrospinal fluid (CSF) tryptophan as a sensitive indicator of brain serotonin (5-HT) turnover. Clinical Research, 18, 671.Google Scholar
Torda, C. (1967) Effect of brain serotonin depletion on sleep in rats. Brain Research, 6, 375–7.Google Scholar
Van Der Velde, C. D. & Gordon, M. W. (1972) Biochemical and pharmacological variations in manic-depressive illness. American Journal of Psychiatry, 129, 337–42.Google Scholar
van Praag, H. M. & Korf, J. (1972) A pilot study of some kinetic aspects of the metabolism of 5-hydroxytryptamine in depressive patients. Biological Psychiatry, 3, 105–12.Google Scholar
van Praag, H. M., Korf, J. & Puite, J. (1970) 5-hydroxyindoleacctic acid levels in the cerebrospinal fluid of depressive patients treated with probenecid. Nature, 225, 1259–60.Google Scholar
Weissman, A. (1973) Behavioral pharmacology of P-chlorophenylalanine (PCPA). In Serotonin and Behavior (eds. Barchas, & Usdin, ). New York.CrossRefGoogle Scholar
Weitzman, E., Rapport, M., McGregor, P. & Jacoby, J. (1968) Sleep patterns of the monkey and brain serotonin concentration: Effects of p-chlorophenylalanine. Science, 160, 1361–3.Google Scholar
Whybrow, P. C. & Mendels, J. (1969) Toward a biology of depression: Some suggestions from neurophysiology. American Journal of Psychiatry, 125, 14911500.Google Scholar
Wilk, S. & Green, J. P. (1972) On the measurement of 5-hydroxyindole acetic acid in cerebrospinal fluid. Journal of Neurochemistry, 19, 2893–5.Google Scholar
Wilson, I. C. & Prange, A. J. Jr., (1972) Tryptophan and mania: theory of affective disorders. Psychopharmacologia, 26, 76 (Supplement)Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.