CALCIUM - BIVALENT CATION IN THE BIVALENT PSYCHOSES

Abstract

Decreases in CSF Ca accompany mood elevation and motor activation in depressed patients [human] undergoing treatment with ECT [electroconvulsive therapy], Li and total sleep deprivation. Decreases in CSF Ca occur during acute psychotic agitation or mania. Periodic recurrences of such agitated states are accompanied by transient increases in serum Ca and P. Serum ion shifts may trigger the more enduring and opposite shifts in CSF Ca and manic behavior. Progressive restriction of dietary Ca was reported to mitigate and finally abolish both rhythmic rises in serum Ca and periodic agitated episodes in 1 psychotic patient [human]. Li, which decreases the efficiency of alimentary Ca absorption, may function similarly. A modest oral Ca lactate supplement seemed to slightly intensify agitation in 6 patients. Dihydrotachysterol (DHT), an analog of vitamin D, which more exactly mimics the increase in both serum Ca and P, appeared in at least 1 periodically psychotic patient to trigger an opposite shift in CSF Ca. In 8 patients, manic symptomatology appeared de novo or grew significantly and substantially worse during 2-6 wk of oral DHT administration. In 12 patients, s.c. injections of synthetic salmon calcitonin (SCT) decreased serum Ca and P, increased CSF Ca and decreased agitation while augmenting depressive symptomatology. SCT also decreased quantified motor activity, frequency and severity of periodic agitated episodes, serum CPK [creatine phosphokinase] and prolactin and nocturnal sleep, while DHT or Ca lactate had opposite effects on the same parameters.