Biogenic amines and affective disorders.

Abstract

In recent years the study of biogenic amine metabolism in patients with affective disorders (depressions and manias) has been stimulated by the increasing evidence that drugs used in the treatment of these disorders produce changes in the metabo­ lism of one of the monoamines (i.e. the catecholamines, norepinephrine, and dopa­ mine, as well as the indoleamine serotonin) (1). These studies, which have demonstrated a number of different biochemical alterations in patients with affective disorders, have contributed substantially to our understanding of the underlying pathophysiology of these disorders. Aspects of this literature have been reviewed frequently during the past several years (1-16). For a number of years investigators have recognized the possibility that different subtypes of depressive or manic disorders might exhibit different specific alterations in the metabolism of the monoamines. It was suggested that studies of biogenic amine metabolism might ultimately contribute to the development of a more mean­ ingful biochemical classification of the affective disorders and a more rational ap­ proach to the treatment of these disorders (2, 17). Since I had the opportunity to prepare a fairly extensive review of this field for the Annual Review of Pharmacology last year (16), I do not repeat much of this material in the present review. Instead, I emphasize studies that have appeared during the past year, focusing principally on those areas of research that now appear most likely to yield biochemical criteria for classifying different types of affective disorders and predicting differential re­ sponses to various forms of treatment.