Differences in the Metabolism of Norepinephrine in Depressions

Abstract

THE PAST decade has witnessed a major advance in the psychiatric treatment of the depressive disorders. For some 30 years, since its introduction by Cerletti and Bini, electroshock treatment (EST) was the major therapeutic modality for the relief of those profound endogenous depressive states which were not improved by psychotherapy, sedatives, or amphetamines. With the advent of a number of new chemotherapeutic agents, alternative avenues of treatment which compare favorably with EST are now available.¹³Because depression is seen in a multiplicity of clinical states, the current pressing problem is the formulation of a relationship between pathophysiology and treatment. One feature which the various therapies for the endogenous depressions have in common is that they exert an effect on the sympathetic nervous system. After EST there is an increase in plasma levels and excretion of catecholamines^29,15and a heightened reactivity of the sympathetic