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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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