Changes on recovery in the concentrations of tryptophan and the biogenic amine metabolites in the cerebrospinal fluid of patients with affective illness

Abstract

SYNOPSIS The concentration of the acid metabolites of dopamine, and 5-hydroxytryptamine (5-HT), homovanillic acid (HVA), and 5-hydroxyindolacetic acid (5-HIAA) respectively, were estimated in the cerebrospinal fluid of patients suffering from either unipolar or bipolar affective illness, both before and after recovery. Significantly low concentrations of HVA and 5-HIAA (P<0·01 and 0·05 respectively) were found in the unipolar depressed group and these did not return to normal on recovery. Depressed bipolar patients had levels within normal limits. In bipolar manic patients the HVA concentration fell on recovery to a level significantly lower ( P <0·05) than controls. There was no difference in the levels of tryptophan in the CSF of any of the groups of patients nor was there any alteration on recovery. There was a high correlation between 5-HIAA and HVA in the same CSF. These findings are against the amine hypothesis which postulated in depression a lowered concentration of transmitter amine at synaptic junction.