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Pterin metabolism in depression: an extension of the amine hypothesis and possible marker of response to ECT

Published online by Cambridge University Press:  09 July 2009

David N. Anderson*
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
Mohammed T. Abou-Saleh
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
James Collins
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
Kevin Hughes
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
Richard J. Cattell
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
Christopher G. B. Hamon
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
John A. Blair
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
Michael E. Dewey
Affiliation:
Department of Psychiatry, Fazakerley Hospital, Liverpool; University Department of Psychiatry, Royal Liverpool Teaching Hospital, Liverpool; Pharmaceutical Sciences Institute, Aston University, Birmingham
*
1 Address for correspondence: Dr D. N. Anderson, Department of Psychiatry, Fazakerley Hospital, Longmoor Lane, Liverpool L9 7AL.

Synopsis

Urinary excretion of neopterins and biopterins was measured in 23 patients with severe depression before and after receiving electroconvulsive therapy (ECT) and 26 healthy control subjects. Patients with psychotic depression and those responding to ECT had neopterin:biopterin (N:B) ratio significantly higher than controls before commencing ECT and positive therapeutic response was associated with reduction of N:B ratio towards control values. As a raised N:B ratio implies failure to convert neopterin to biopterin it is possible that reduced availability of tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, serotonin and dopamine, may exert rate limiting control over the synthesis of monoamines implicated in the pathogenesis of depressive disorders. The N:B ratio may be a marker for certain depressive subtypes and response to ECT.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

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