title: Mania: gender, transmitter function, and response to treatment.
abstract: Noradrenergic and GABA systems may be involved in mania, but there is little information about relationships between the function of these systems and response to specific antimanic treatments. We investigated relationships between indices of catecholamine or GABA system function, pretreatment mania severity and antimanic response to divalproex, lithium, or placebo. Plasma GABA and urinary excretion of catecholamine metabolites were measured before randomization to lithium, divalproex or placebo in patients hospitalized for manic episodes. Severity of mania was evaluated using the Manic Syndrome, Behavior and Ideation and Mania Rating Scale scores from the SADS-C. Multiple regression analysis showed that pretreatment plasma GABA was related to severity of manic symptoms. This relationship seemed stronger in women. Multiple regression analysis showed that pretreatment levels of urinary MHPG correlated with improvement in manic syndrome scores. These data suggest that GABA and norepinephrine may be related to different aspects of the manic state and to its pharmacologic sensitivity.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School, 77030, USA. aswann@msi.uth.tmc.edu
authors.forename: A C
authors.initials: AC
authors.lastname: Swann
authors.forename: F
authors.initials: F
authors.lastname: Petty
authors.forename: C L
authors.initials: CL
authors.lastname: Bowden
authors.forename: S C
authors.initials: SC
authors.lastname: Dilsaver
authors.forename: J R
authors.initials: JR
authors.lastname: Calabrese
authors.forename: D D
authors.initials: DD
authors.lastname: Morris
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000652:urine; D008875:Middle Aged; D009638:Norepinephrine / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000502:physiology*
chemical_list: D018692:Antimanic Agents; D016651:Lithium Carbonate; D008734:Methoxyhydroxyphenylglycol; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D009638:Norepinephrine