Studies on sodium transfer and 5-hydroxyindoles in depressive illness

An investigation of Coppen (1960)'s claim that the rate of transfer of "4Na from blood to cerebrospinal fluid was lower in patients with a depressive illness than in schizophrenic patients" is investigated and the 24Na transfer rates are compared.

Abstract

Coppen (1960) has claimed that the rate of transfer of "4Na from blood to cerebrospinal fluid was lower in patients with a depressive illness than in schizophrenic patients and that the rate of transfer returned to normal as the patients improved clinically.The present communication describes an investigation of this claim and compares the 24Na transfer rates in groups of patients with depressive illness and schizophrenia.Data on the levels of 5-hydroxyindoles in blood and cerebrospinal fluid of these patients are also presented. SUBJECTS AND METHODSSpecimens of blood and cerebrospinal fluid were ob- tained from 28 suitable patients who agreed to cooperate in the investigation.A psychiatric evaluation of the patients was made by two of the authors.For the depres- sive patients the interview technique described by Affleck, Forrest, and Martin (1961) was employed in which 17 items were assessed on a three-point scale.This resulted in a symptom scattergram and on the basis of this a second rating on a five-point scale was made (1 = symp- tom free, 5 = severely disturbed).For the schizophrenic patients a list of 18 items covering affect, ideation, feelings of passivity, and perceptual disturbance was used and a rating made on a five-point scale (1 = symptom free, 5 = severely disturbed).Only patients whose illness was of at least moderate severity were included and 50% of the patients were rated as severely or very severely disturbed, i.e., rating 4 or 5. None of the patients had received electro-convulsive treatment in the three months before the study.The rate of entry of 24Na into cerebrospinal fluid was determined in a manner similar to that described by Coppen (1960).On the morning of the investigation the patients were confined to bed.One hundred microcuries of 24Na in the form of an isotonic solution of sodium chloride was injected intravenously and 30 minutes later each patient received morphine (i grain) and hyoscine (T' grain) by injection as premedication to produce relaxation during the lumbar puncture.Approximately one hour after injection of 24Na, 10 ml. of cerebrospinal