title: State dependence of noradrenergic activity in a rapidly cycling bipolar patient.
abstract: Plasma levels of the major norepinephrine (NE) metabolite, 3-methoxy-4-hydroxyphenylglycol (MHPG), were measured in a rapidly cycling bipolar patient and her first-degree relatives. The mood state dependence and the reciprocal relationship between noradrenergic and cholinergic activity were investigated by assessing mood, thought disorder, and plasma MHPG following the infusion of physostigmine. A correlation was found between plasma MHPG and mood states, with exceedingly high levels during mania and hypomania. Levels were significantly decreased by ECT or combined lithium and chlorpromazine administration. A pathologic diurnal MHPG pattern was detected during periods of abnormal mood changes. Infusion of physostigmine led to a prompt reduction in MHPG release and a marked decline in mood-state measurements and the overall level of thought disorder. Muscarinic receptors exerting negative feedback control over the synthesis and/or release of NE may have become supersensitive as a consequence of alpha 2-adrenoceptor densensitization.
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000097:blood / Q000235:genetics / Q000523:psychology*; D002746:Chlorpromazine / Q000494:pharmacology; D002940:Circadian Rhythm; D004565:Electroconvulsive Therapy; D005246:Feedback; D005260:Female; D006018:Glycols / Q000097:blood*; D006801:Humans; D008094:Lithium / Q000494:pharmacology; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood*; D008875:Middle Aged; D009638:Norepinephrine / Q000378:metabolism; D010830:Physostigmine / Q000494:pharmacology; D011941:Receptors, Adrenergic / Q000187:drug effects; D011976:Receptors, Muscarinic / Q000187:drug effects
chemical_list: D006018:Glycols; D011941:Receptors, Adrenergic; D011976:Receptors, Muscarinic; D008734:Methoxyhydroxyphenylglycol; D008094:Lithium; D010830:Physostigmine; D002746:Chlorpromazine; D009638:Norepinephrine