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Renin and Aldosterone Relationships in Manic Depressive Psychosis

Published online by Cambridge University Press:  29 January 2018

R. P. Hullin
Affiliation:
University of Leeds; Regional Metabolic Research Unit, High Royds Hospital, Menston, Ilkley LS29 6AQ
T. C. Jerram
Affiliation:
Departments of Biochemistry and Psychiatry, University of Leeds, Leeds LS2 9JT
M. R. Lee
Affiliation:
Clinical Pharmacology, Department of Medicine, Leeds General Infirmary, Leeds LS1 3EX
M. J. Levell
Affiliation:
Division of Steroid Endocrinology, Department of Chemical Pathology, University of Leeds, Leeds LS2 9LN
S. P. Tyrer
Affiliation:
University of Leeds, Leeds LS2 9JT; Department of Psychiatry, Charing Cross Hospital (Fulham), London W6 8RF

Extract

SUMMARY The paper describes a two-month period of study in four bipolar manic-depressive patients in a metabolic ward. Plasma renin activity, packed cell volume, plasma sodium and potassium were determined at intervals. Twenty-four-hour urinary sodium, potassium and creatinine were also estimated daily. Aldosterone production rate was measured on two occasions for each patient. Three of the patients showed at least one episode each of mania and depression during the study, while the fourth patient, who was receiving prophylactic lithium throughout, had one ten-day depressive episode but was otherwise normal.

No obvious relationship between mood and plasma renin activity was observed, but the group showed a high resting renin activity, a blunted renin response to posture, and inappropriate aldosterone production rates for the renin activity found.

It is postulated that a primary defect in the aldosterone-renin system may be present in bipolar manic-depressive psychosis.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1977 

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References

Allsopp, M. N. E., Levell, M. J., Stitch, S. R. & Hullin, R. P. (1972) Aldosterone production rates in manic-depressive psychosis. British Journal of Psychiatry, 120, 399404.Google Scholar
Allsopp, M. N. E., Levell, M. J. & Hullin, R. P. (1977) A manic-depressive psychotic patient with a short cycle of unusual periodicity. Psychological Medicine. Submitted for publication.Google Scholar
Aronoff, M. S., Evens, R. G. & Durell, J. (1970) Effect of lithium salts on electrolyte metabolism. Journal of Psychiatric Research, 8, 139–59.Google Scholar
Boyd, R., Adamson, A. R., Arnold, M., James, V. H. T. & Peart, W. S. (1972) The role of angiotensin II in the control of aldosterone in man. Clinical Science, 42, 91104.Google Scholar
Brown, J. J., Chinn, R. H., Fraser, R., Lever, A. F., Morton, J. J., Robertson, J. I. S., Tree, M., Watte, M. A. & Park, D. M. (1973) Recurrent hyperkalaemia due to selective aldosterone deficiency: correction by angiotensin infusion. British Medical Journal, i, 650–4.Google Scholar
Cope, C. L. & Loizou, S. (1973) Simplication of urinary aldosterone measurement by radioimmunoassay. Journal of Clinical Pathology, 26, 628–34.Google Scholar
Coppen, A. & Shaw, D. M. (1963) Mineral metabolism in melancholia. British Medical Journal, ii, 1439–44.Google Scholar
Coppen, A. & Shaw, D. M. Malleson, A. & Costain, R. (1966) Mineral metabolism in mania. British Medical Journal, i, 71–5.Google Scholar
Davies, J. O. (1972) Are there unidentified factors in the control of aldosterone secretion? (Editorial) New England Journal of Medicine, 286, 100–1.Google Scholar
Dluhy, R. G., Axelrod, L., Underwood, R. H. & Williams, G. H. (1972) Studies of the control of plasma aldosterone concentration in normal man. II. Effect of dietary potassium and acute potassium infusion. Journal of Clinical Investigation, 51, 1950–7.Google Scholar
Fleischer, Von K., Biniek, E., Klaus, D. & Tolle, R. (1971) Beeinflussung des Plasmarenins und der pressorischen Ansprechbarkeit auf Angiotensinamid durch Lithium beim Menschen. Arzneimittel-Forschung, 21, 1363–4.Google Scholar
Gordon, R. D., Kuchel, O., Liddle, G. W. & Island, D. P. (1967) Role of the sympathetic nervous system in regulating renin and aldosterone production in man. Journal of Clinical Investigation, 46, 599605.Google Scholar
Gutman, Y., Tamir, N. & Benzakein, F. (1973) Effect of lithium on plasma renin activity. European Journal of Pharmacology, 24, 347–51.Google Scholar
Hullin, R. P., Bailey, A. D., McDonald, R., Dransfield, G. A. & Milne, H. B. (1967) Body-water variations in manic-depressive psychosis. British Journal of Psychiatry, 113, 584–92.Google Scholar
Hullin, R. P., Swinscoe, J. C., McDonald, R. & Dransfield, G. A. (1968) Metabolic balance studies on the effect of lithium salts in manic-depressive psychosis. British Journal of Psychiatry, 114, 1561–73.Google Scholar
Jowett, T. P., Slater, J. D. H., Piyasena, R. D. & Ekins, R. P. (1973) Radioimmunoassay of aldosterone in plasma and urine. Validation of a novel separation technique and a rapid urine assay. Clinical Science, 45, 607–23.Google Scholar
Kem, D. C., Gomez-Sanchez, C., Kramer, N. J., Holland, O. B. & Higgins, J. (1975) Plasma aldosterone and renin activity response to ACTH infusion in dexamethasone-suppressed normal and sodium-depleted man. Journal of Clinical Endocrinology and Metabolism, 40, 116–24.Google Scholar
Kierkegaard-Hansen, A. (1974) The effect of lithium on blood pressure and on plasma renin substrate and renin in rats. Acta Pharmacologica et toxicologica, 35, 370–8.Google Scholar
Lee, M. R. (1969) Renin and Hypertension: a Modern Synthesis. London: Lloyd-Luke.Google Scholar
Mayes, D., Furuyama, S., Kem, D. C. & Nugent, C. A. (1970) A radioimmunoassay for plasma aldosterone. Journal of Clinical Endocrinology, 30, 682–5.CrossRefGoogle ScholarPubMed
Murphy, D. L., Goodwin, F. K. & Bunney, W. E. (1969) Aldosterone and sodium response to lithium administration in man. Lancet, ii, 458–60.Google Scholar
Rees, J. R., Allsopp, M. N. E. & Hullin, R. P. (1974) Plasma concentrations of tryptophan and other amino-acids in manic-depressive patients. Psychological Medicine, 4, 334–7.Google Scholar
Ross, E. J. (1975) Aldosterone and Aldosteronism, London: Lloyd-Luke.Google Scholar
Ryan, J. W., McKenzie, J. K. & Lee, M. R. (1968) A simple rapid method for the quantitative assay of renin in rabbit plasma. Biochemical Journal, 108, 679–85.Google Scholar
Sassard, J., Vincent, M., Annat, G. & Bizollon, C. A. (1976) A kinetic study of plasma renin and aldosterone during changes of posture in man. Journal of Clinical Endocrinology, 42, 20–7.CrossRefGoogle ScholarPubMed
Schildkraut, J. J. (1974) Biogenic amines and affective disorders. Annual Reviews of Medicine, 25, 333–48.Google Scholar
Shopsin, B., Sathananthan, G. & Gershon, S. (1973) Plasma renin response to lithium in psychiatric patients. Clinical Pharmacology and Therapeutics, 14, 561–4.Google Scholar
Varley, H. (1967) In Practical Clinical Biochemistry, pp 197–8. London: William Heinemann.Google Scholar
Wilcox, C. S., Aminoff, M. J., Kurtz, A. B. & Slater, J. D. H. (1974) Comparison of the renin response to dopamine and noradrenaline in normal subjects and patients with autonomic insufficiency. Clinical Science and Molecular Medicine, 46, 481–8.Google Scholar
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