CSF inositol does not predict antidepressant response to inositol

Levine, Joseph; Kurtzman, Larisa; Rapoport, A.; Zimmerman, Joseph; Bersudsky, Yuly; Shapiro, Joseph I.; Belmaker, R.H.; Agam, Galila

doi:10.1007/bf01271260

Cited by 24 publications

(8 citation statements)

References 12 publications

(6 reference statements)

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“…The present study was a satellite part of a previous study [33] approved by the local Helsinki committee and the ministry of health. It included two groups.…”

Section: Methodsmentioning

confidence: 99%

High Serum and Cerebrospinal Fluid Ca/Mg Ratio in Recently Hospitalized Acutely Depressed Patients

et al. 1999

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Calcium (Ca) and magnesium (Mg) are involved in many processes related to depression. Evaluations of serum and plasma Ca and Mg levels in depressive disorders do not show consistent results. The few studies that examined their cerebrospinal fluid (CSF) levels tended to find no differences between depressed patients and controls. Because both hypercalcemia and hypomagnesemia are associated with depression, and as Mg may function as a Ca antagonist, it is suggested that the relationship between these cations could be different in depressed patients and controls. We examined CSF and serum Ca and Mg in acutely depressed patients diagnosed as having major depressive disorder or being in a depressive episode of bipolar disorder. Controls were subjects undergoing lumbar puncture as part of an evaluation for headache or suspected meningitis and found to demonstrate no physical or mental disorder. Serum and CSF Ca/Mg ratios were found to be elevated in the depressed patients compared with the controls. A retrospective analysis of previous trials assessing serum/plasma or CSF Ca and Mg does not seem to refute the findings of this study. We further discuss our findings in their relation to the acuteness of the depressive disorders.

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“…The present study was a satellite part of a previous study [33] approved by the local Helsinki committee and the ministry of health. It included two groups.…”

Section: Methodsmentioning

confidence: 99%

High Serum and Cerebrospinal Fluid Ca/Mg Ratio in Recently Hospitalized Acutely Depressed Patients

et al. 1999

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“…The study was an add-on to another research project approved by the review board and ethics committee [25]. Thirteen patients participated in the study, 2 males, 11 females, mean age 56 (range 29-70).…”

Section: Methodsmentioning

confidence: 99%

Cerebrospinal Cytokine Levels in Patients with Acute Depression

Levine

Barak²,

Chengappa³

et al. 1999

Neuropsychobiology

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309

183

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There is increasing evidence for an association between the alteration of cytokine concentrations in blood and the pathophysiology of depressive disorders. Studies in humans have not investigated CSF cytokine concentrations and their relationship to depressive disorders. This study reports on the association of the CSF concentration of proinflammatory cytokines, IL-1β, IL-6 and TNFα, and major depressive disorders. CSF samples were obtained from 13 hospitalized patients with acute unmedicated severe depression and were compared with 10 control subjects. Compared to the control group, the depressed patient group had higher CSF concentrations of IL-1β, lower IL-6 and no change in TNFα. A positive correlation was found between serum IL-1β and the severity of depression. These results indicate a unique profile for CSF proinflammatory cytokines in acute depression. These findings merit further investigation and if replicated may possibly offer immunological treatment options for depression.

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“…Barkai et al (2) reported that inositol is reduced in cerebrospinal fluid in patients with bipolar and unipolar depression, although others could not replicate this finding (3). In a double-blind, controlled study (4), Levine et al administered 12 g/day of inositol or placebo to 28 depressed patients for 4 weeks.…”

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confidence: 99%

Reduced frontal cortex inositol levels in postmortem brain of suicide victims and patients with bipolar disorder

1997

AJP

140

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nositol is a simple polyol isomer of glucose that serves as a precursor in the phosphatidylinositol second messenger cycle (1). Barkai et al. (2) reported that inositol is reduced in cerebrospinal fluid in patients with bipolar and unipolar depression, although others could not replicate this finding (3). In a double-blind, controlled study (4), Levine et al. administered 12 g/day of inositol or placebo to 28 depressed patients for 4 weeks. Inositol treatment reduced scores on the Hamilton Depression Rating Scale significantly more than placebo.We were able to measure inositol and inositol monophosphatase, the enzyme that forms inositol in brain, in postmortem brain specimens from patients with bipolar affective disorder, suicide victims, and normal comparison subjects. METHODBrain specimens of eight patients with bipolar disorder (six women and two men), 10 suicide victims (six women and four men), and 10 normal comparison subjects (four women and six men) were obtained at autopsy from the Medical Examiner's Office of Washington, D.C. Blood and urine samples were collected at the same time for toxicological analysis and for neuroleptic level determination. None of the subjects had measurable levels at the time of death. Level of lithium in the brains of the patients with bipolar disorder and the suicide victims was measured by flame emission spectroscopy; lithium was undetectable in all subjects except for three of the patients with bipolar disorder (levels of 0.35, 0.48, and 0.23 mmol/kg wet weight). Most of the patients with bipolar disorder had ceased taking psychoactive medication in the week before death; however, two had injested alcohol, and one had been taking thioridazine in addition to lithium. One suicide victim had a history of barbiturate use, and another had been taking codeine.Psychiatric diagnosis was determined by independent review of medical records by at least two psychiatrists. This review revealed that seven suicide victims had evidence of depression, and one may have suffered from delusional disorder; no information was available for the remaining two suicide victims. Methods of suicide were jumping (N=3), hanging (N=3), gunshot (N=1), and overdose (N=3). Causes of death for the patients with bipolar disorder were drowning (N=1), hanging (N=1), car accident (N=1), cancer (N=1), and cardiopulmonary arrest (N=4). One normal comparison subject had died as a result of a fall, and another was a homicide victim; the rest had died of cardiovascular disease. Two patients with bipolar disorder were black, and six were white; two of the suicide victims were black, and eight were white; and nine of the 10 normal comparison subjects were black.After collection from autopsy, brain tissue was stored at -70°C until dissection for this study. Postmortem interval was defined as the time from death until the brain was removed and frozen. The mean ages of the patients with bipolar disorder, the suicide victims, and the normal comparison subjects were 51.4 (range=31-83), 53.6 (range=29-86), and 53.6 years (...

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CSF inositol does not predict antidepressant response to inositol

Cited by 24 publications

References 12 publications

High Serum and Cerebrospinal Fluid Ca/Mg Ratio in Recently Hospitalized Acutely Depressed Patients

High Serum and Cerebrospinal Fluid Ca/Mg Ratio in Recently Hospitalized Acutely Depressed Patients

Cerebrospinal Cytokine Levels in Patients with Acute Depression

Reduced frontal cortex inositol levels in postmortem brain of suicide victims and patients with bipolar disorder

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