THE GROWTH-HORMONE RESPONSE TO APOMORPHINE AT 4 DAYS POSTPARTUM IN WOMEN WITH A HISTORY OF MAJOR DEPRESSION

We have examined the responsiveness of dopamine sensitive neurones in the postpartum period in woman with a history of major depression who are at high risk of experiencing a recurrence of illness in the postpa rtum period. Fourteen women were assessed at 36 weeks of pregnancy and during the 3 months following delivery, using the Schedule for Affect ive Disorders and Schizophrenia, including its change version. They we re not depressed at initial assessment. Five of the 14 women went on t o experience a postpartum relapse (2 major depressive disorder, 2 gene ralised anxiety disorder, 1 panic disorder). On the fourth day postpar tum, ie before relapse, the growth hormone response to the dopamine ag onist apomorphine was measured as an index of the functional state of hypothalamic dopamine D2 receptors. Women who subsequently relapsed ha d a significantly greater growth hormone response to apomorphine than those who remained well. This was particularly marked in women with an xiety/panic. The development of increased sensitivity of hypothalamic dopamine D2 receptors in the postpartum period appears to predict the onset of depressive and anxiety disorders.