Aminergic Studies and Cerebrospinal Fluid Cations in Suicide

Abstract

Cerebrospinal fluid 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) measurements have been collected over six years from 275 drug-free, recently hospitalized psychiatric patients, almost exclusively females. In accord with other observations from various countries, patients who had attempted suicide shortly before admission had significantly lower mean CSF 5-HIAA concentration and this was particularly true for those using violent methods. This finding could be replicated in five subsequent samples of patients evaluated separately and using different assay procedures, and proved to be independent of the clinical diagnoses. CSF HVA also showed similar tendencies but it had much larger variance with respect to suicide attempts and therefore fell short of statistical significance. In two patient populations CSF calcium and magnesium measurements have been obtained. CSF calcium did not prove to be related to either suicidal behavior or the diagnosis of major depression; on the other hand, CSF magnesium was found to be significantly lower in the suicide attempters and also correlated with CSF 5-HIAA. Nonsuicidal depressives had comparable CSF calcium and magnesium levels to the controls.

Extrapyramidal symptoms and antidepressant drugs: neuropharmacological aspects of a frequent interaction in the elderly

“…Changes in CSF levels of 5-hydroxyindoleacetic acid (5-HIAA) have been employed to provide an indirect measure of serotonin brain turnover 24 and, with the limits imposed by the yet unclear relationship between 5-HIIA levels and brain serotonin metabolism, have suggested a reduced serotoninergic activity in depressed subjects. [25][26][27][28] However, these data are not conclusive since in other clinical studies significant differences in CSF 5-HIAA between depressed and healthy subjects have not been observed. 29 Some forms of depression are related to a decreased Molecular Psychiatry responsiveness of 5-HT1A receptors, as suggested by studies employing a 5-HT1-mediated neuroendocrine model.…”

Platelet and serum calcium and magnesium concentration in suicidal and non‐suicidal schizophrenic patients

“…16,17 To date, only a few studies have been performed on Mg and Ca concentration in patients with schizophrenia and consistent results have not been obtained. [18][19][20][21][22][23][24][25][26][27][28][29][30][31] The majority of investigations determined the concentration of Mg and Ca in serum or plasma, which does not reflect the true state of the supply of the organism with Mg, as only 1% of the Mg is in blood plasma. With regard to cells it is considered that different types of cells have different kinetic interchange of Mg and other electrolytes and it is still not completely clear which type of cell best reflects the status of Mg and Ca in the organism.…”

“…2), considered a Ca antagonist, may represent a compensatory attempt to restrain Ca activity because the platelet Ca/Mg ratio is unchanged compared to the healthy control group. Some authors have reported a higher 22,23 or decreased 24,25,29 Mg concentration in the CSF of schizophrenic patients, a decreased plasma Mg 18,26,27 or unchanged plasma Mg concentration before neuroleptic therapy and a decreased level after neuroleptic therapy [19][20][21] schizophrenic patients. A lower Mg level in the erythrocytes of schizophrenic patients 30 has been obtained.…”

“…This is because of inhibition of NMDA receptors on GABA neuron (main inhibitory pathway in the CNS) and there are no inhibitions of the major excitatory pathway that innervates the cerebrocortical and limbic brain region . To date, only a few studies have been performed on Mg and Ca concentration in patients with schizophrenia and consistent results have not been obtained . The majority of investigations determined the concentration of Mg and Ca in serum or plasma, which does not reflect the true state of the supply of the organism with Mg, as only 1% of the Mg is in blood plasma.…”

Magnesium in the Central Nervous System

“…In contrast to peripheral changes in plasma or serum, changes within the CNS point to a brain Mg deficiency. In subjects with MD, a decrease in CSF Mg concentration has been confirmed (Banki et al, 1986;Banki et al, 1985). A more recent study found an increase in the Ca/Mg ratio of CSF in patients with depression (Levine et al, 1999).…”