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From: brianm@bigtuna.UUCP (Brian Martin)
Newsgroups: net.med
Subject: Re: chemical depression?
Message-ID: <163@bigtuna.UUCP>
Date: Wed, 14-Aug-85 21:51:25 EDT
Article-I.D.: bigtuna.163
Posted: Wed Aug 14 21:51:25 1985
Date-Received: Tue, 20-Aug-85 06:58:55 EDT
References: <207@nrcvax.UUCP>
Reply-To: brianm@bigtuna.UUCP (Brian Martin)
Organization: University of Hawaii, Bekesy Lab, Neurophysiology
Lines: 37


Chemical depression is a misnomer--it refers to a theoretical subclassification
of major depression, an affective disorder requiring psychiatric treatment.
Basically, one category of patients with major depression have unusually
low levels of norepinephrine (NE) metabolites in their urine, and it's been
observed that these patients respond favorably to drugs that tend to increase
the availability of NE in the central nervous system (CNS).  On the other hand,
another category of patients with major depression have unusually low levels
of serotonin (5-HT) metabolites in their cerebro-spinal fluid, and this group
of patients responds favorably to drugs that tend to increase the availability
of 5-HT in the CNS.  And there's yet a third type of major depression in which
patients demonstrate an abnormal response to the hormone dexamethosone.

The antidepressant medications used to treat these illnesses fall into two
major categories:  tricyclic antidepressants (TCA) and monoamine oxidase
inhibitor antidepressants (MAO-I).  (Lithium carbonate is also used to
treat certain types of depression.) They are organized into various
subclasses depending on their relative specificities for neural membrane
receptor proteins.  These drugs can affect a large number of organ systems
within the body; serious side effects, even death can result if the
antidepressant medication is improperly chosen or prescribed (for example, a
person on MAO-I therapy could die from taking certain non-prescription cold
remedies).  Because of this, antidepressant therapy should only be administered
by a properly trained physician, preferably a psychiatrist--one who can do
a complete medical evaluation, who understands the various and many times
complex interactions between the body's organ systems, and who is
well-versed in the use of antidepressants.

There are a number of other types of depression which fit neither of the 
classes described above, and which respond only marginally if at all to
antidepressant medication.  These people generally respond quite well to one of
the various forms of psychotherapy currently practiced.

Hope this answers some of your questions.

Brian Martin
University of Hawaii School of Medicine