Mania: gender, transmitter function, and response to treatment

Noradrenergic and GABA systems may be involved in mania, but there is littl e information about relationships between the function of these systems and response to specific antimanic treatments. We investigated relationships b etween indices of catecholamine or GABA system function, pretreatment mania severity and antimanic response to divalproex, lithium, or placebo. Plasma GABA and urinary excretion of catecholamine metabolites were measured befo re randomization to lithium, divalproex or placebo in patients hospitalized for manic episodes. Severity of mania was evaluated using the Manic Syndro me, Behavior and Ideation and Mania Rating Scale scores from the SADS-C. Mu ltiple regression analysis showed that pretreatment plasma GABA was related to severity of manic symptoms. This relationship seemed stronger in women. Multiple regression analysis showed that pretreatment levels of urinary MH PG correlated with improvement in manic syndrome scores. These data suggest that GABA and norepinephrine may be related to different aspects of the ma nic state and to its pharmacologic sensitivity. (C) 1999 Elsevier Science I reland Ltd. All rights reserved.