Depressive Illness
Advances in Biological Psychiatry Vol. 7 Series Editors J. Mendlewicz, Brussels, and H.M. van Praag, Utrecht S. Karger' Basel. Miinchen. Paris' London' New York' Sydney
Symposium on Depressive Illness, Amsterdam, September 11~12, 1980 Depressive lllness Biological and Psychopharmacological Issues Volume Editors J. Mendlewicz, Brussels, A. Coppen, Epsom, and H.M. van Praag, Utrecht 45 figures and 63 tables, 1981 s. Karger Basel Mimchen. Paris London New York Sydney
Advances in Biological Psychiatry NatIOnal LIbrary of MedIcIne, Cataloging in Publication Depressive illness, biological and psychopharmacological issues Volume editors, 1. Mendlewicz and H.M. van Praag. - Basel, New York, Karger, 1981. (Advances in biological psychiatry, v. 7) Proceedings of the fint joint meeting between the Interdisciplinary Society of Biological Psychiatry and the World Psychiatric Association. WI Ad44 v. 7 / [WM 171 D4247] ISBN 3-8055-2482-X Drug Dosage The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All righ ts reserved No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 1981 by S. Karger AG, P.O. Box CH-4009 Basel (Switzerland) Printed in Switzerland by Thiir AG, Offsetdruck, Pratteln ISBN 3-8055-2482-X
Contents Mendlewicz, J. (Brussels): Introduction............................ VII Carroll, B.1.; Feinberg, M.; Greden, J.F.; Tarika, J.; Alabala, A.A.; Haskett, R.F.; James, N.M; Kronfol, Z.; Lohr, N.; Steiner, M.; de Vigne, J.P.; Young, E. (Ann Arbor, Mich.): Standardization of the Dexamethasone Supression Test for the Diagnosis of Melancholia....................................... I Winokur, G. (Iowa City, Iowa): Classification: The Bridge over the River Styx... 14 Sedvall, G. (Stockholm): Neurotransmitter Disturbances and Predisposition to Depressive Illness.......................................... 26 Gottfries, CG. (Hi sings Backa): Amines, Aging and Affective Disorders... 34 Gold, P. w.; Post, R.M; Weingartner, H.; Goodwin, F.K. (Bethesda, Md.): Central Peptide Function in Affective Illness: Arginine Vasopressin as Model System........ 42 Bunney, W.E. Jr.; Garland. B. (Bethesda, Md.): Receptor Function in DepressIOn.... 71 Wood, K.; Coppen, A. (Epsom): Platelet Alpha-Adrenoreceptor Sensitivity III Depressive Illness.......................................... 85 Sulser, F. (Nashville, Tenn.): New Perspectives on the Action of Antidepressant drugs: Regulation of Central Adrenergic Receptor Function................. 90 Jenner, P.; Marsden, CD. (London): POSSible Neuronal Mechamsms Involved in the Production of the Disinhibitory Action of Sulpiride.................. 100 Young, S.N. (Montreal, Que.): The Potential for the Use of Tryptophan and Other Amine Precursors in the Treatment of Affective Disorders.............. 113 Youdim, MB.H.; Finberg, J.P.M. (Haifa): Use of Selective Acetylenic MAO Inhibitors in Depression........................................ 126 Borenstein, P.; Gekiere, F. (Paris): Sulpiride, Psychosis, and Mood... 138 Aylward, M.; Maddock, J.; Dewland, P.M; Lewis, P.A. (Mid Glamorgan): Sulpiride in Depressive Illness...................................... 154 Nissen, G. (Wiirzburg): Use of Psychotropics in Childhood (with Special Reference to Sulpiride)... 167 Leonard, B.E. (Galway): Second Generation of Antidepressants... 174 Deakin, J.F. w.; Crow, T.1.; Johnstone, E.C; Frith, CD.; Lawler, P.; Macimillian, J.F.; McPhersen, K.; Owens, D.G.C; Price, J.S.; Stevens, M. (Harrow): ATrial of Real versus Simulated Electroconvulsive Therapy in 70 Depressed Patients... 188
Contents VI Robinson, D.S.; Cooper, T.B.; Nies, A.; Howard, D.B.; Corcella, J. (Huntmgton, W.Va./ Orangenburg, N.Y./Coatesville, Pa./Burlington, VL): Plasma Levels of AntIdepressants and Therapeutic Effects... 199 Glen, I. (Edinburgh): Lithium and Antidepressants in the Prophylaxis of Depression... 209 Angst,!. (Zurich): Clinical Indications for a Prophylactic Treatment of DepressIOn... 219 Weissman, M.M. (New Haven, Conn.): Antidepressants and Psychotherapy m Depression... 231 Subject Index... 240
Introduction This is the first joint meeting between the Interdisciplinary Society of Biological Psychiatry and the World Psychiatric Association (WPA). During the last 30 years, we have witnessed significant progress in the management, treatment and understanding of depressive illness. Still, basic questions such as the mechanisms of action of antidepressants, EeT and lithium remain unclear, and although most researchers are today convinced that many types of depression have a biological substrate, unequivoqual evidence of one or more specific biological abnormality in depression is still lacking. One more puzzling issue, we feel, is the problem of classification of depressive subgroups (often raised in depressive research) and the necessity to support clinical classification with specific and reliable biological parameters. These issues will be discussed in this publication. 1. Mendlewicz, Brussels