The excretion of tyramine sulphate after challenge with an oral load o
f tyramine was assessed in recently detoxified, clinically depressed a
lcoholics and a matched group of major depressives. Tyramine excretion
in the alcohol group (mean 5.95+/-3.28 mg/3h SD) was in the range pre
viously observed in controls and was significantly higher than in the
matched depressives (mean 3.43+/-2.37 mg/3 h SD). Tyramine sulphate ex
cretion has been suggested as a genetic vulnerability marker for major
depression. This study suggests that depression associated with alcoh
ol withdrawal is not characterised by decreased tyramine sulphate excr
etion after oral tyramine challenge, such decreased conjugation only b
eing present, perhaps, in those patients with pre-existing endogenous
depressive vulnerability. Although a genetic link between alcoholism a
nd depression exists, these results support the absence of such a link
to major depression.