Li inhibition of noradrenergic adenylate cyclase may be due to inhibition by Li of agonist-induced increases in GTP binding to G-protein. Such inhibition by Li of G-protein function could have effects on phosphatidyl-inositol-mediated second messenger systems as well as on cyclic AMP-mediated systems. However, Sherman, Berridge and others have proposed that Li affects phosphatidylinositol metabolism by inhibiting inositol-1-phosphatase. We recently have been able to measure inositol-1-phosphatase in human red blood cells. Preliminary data on patients treated with Li compared with controls suggests that the enzyme is indeed inhibited in vivo in patients undergoing Li treatment. However, a series of experiments in rats on addition of inositol to Li treatment did not find that inositol could reverse Li effects. Chronic oral high dose inositol does not reverse Li-induced polyuria (measured by polydipsia), Li-induced weight loss or Li-induced depression of exploratory behavior. These results suggest that Li inhibition of inositol-1-phosphatase indeed occurs in vivo. However, the physiological significance of inositol-1-phosphatase inhibition is not yet established.

Animals↗

PubMed1988

Cyclic AMP second-messenger signal amplification in depression.

Beta-adrenergic-mediated cyclic AMP accumulation was reduced in lymphocytes obtained from depressed patients from that observed in an age- and sex-matched group of control subjects. Among the depressed patients, those not responding to treatment showed significantly lower pretreatment responses to isoproterenol compared with patients who exhibited significant clinical improvement during antidepressant treatment. Late-night (terminal) insomnia was significantly associated with the blunted response to beta-adrenergic stimulation. In depressed patients with the lowest isoproterenol response, the effect of forskolin (which acts distal to the receptor and directly stimulates the catalytic subunit) on cyclic AMP accumulation was also significantly decreased. This suggests that post-receptor modulations of signal amplification also play a role in the reduced response to beta-adrenergic stimulation in depression.

Adult↗

PubMed1987

Aryl sulfatase A deficiency in psychiatric and neurologic patients.

Two hundred ninety-five psychiatric and neurologic patients were randomly screened for aryl sulfatase A (ASA) activity in lymphocyte extracts. Two of these patients showed very low ASA activity, in the range of metachromatic leukodystrophy (MLD)-affected patients. The residual activity in these low ASA patients showed normal enzyme behavior with regard to ASA kinetic features and the ability to catabolize 14C labeled sulfatide by intact fibroblasts. Taking into account that approximately 3% of the general population are homozygous for the pseudo-aryl sulfatase A gene and are clinically unaffected, the data obtained here indicate that the patients studied in this work, as well as most psychiatric patients reported in the literature with low ASA activity, represent the normal ASA polymorphism. Thus, the very low ASA activity patients are in fact homozygous for the pseudo-deficient allele, which does not result in clinical abnormalities. The clinical symptoms in these psychiatric patients and probably other "variant" MLD patients are therefore not related to low ASA activity.

Bipolar Disorder↗

PubMedDate not supplied

Effects of haloperidol on human plasma magnesium.

The effect of haloperidol treatment on human plasma levels of magnesium (Mg), calcium (Ca) and phosphorus (P) was assessed. Haloperidol treatment significantly reduced plasma Mg but not plasma Ca or P levels. This finding contrasts with studies using other neuroleptics where reductions in both Mg and Ca concentrations were observed. The addition of lithium to haloperidol treatment resulted in an elevation of plasma Mg, but not Ca or P, to levels significantly greater than those at baseline. The reduction of Mg levels by haloperidol may reflect the ion's involvement in the pathology of psychosis and/or in the mechanism of generating extrapyramidal side effects.

Adolescent↗

PubMedDate not supplied

Lithium follow-up in general practice.

Lithium salts have been used in medicine for over a century and are a widely accepted treatment. Clinical practice in the London borough of Barnet led us to suspect that agreed guidelines were not being followed. We checked them against published guidelines and followed up their implementation. A list of patients on lithium was obtained from the local biochemistry laboratory and a representative sample extracted. We looked at the frequency of laboratory testing and compared it with the guidelines. We found that the standards for lithium therapy follow-up were not being met and that while we awaited the outcome of our consultant psychiatrists' committee deliberations, the recommendations were not being implemented. A lithium register or clinic needs to be established in the area, and there is also a need for more reliable and effective implementation of clinical audit recommendations.

Antimanic Agents↗