TI: AFFECTIVE AND ATOPIC DISORDERS AND CYCLIC AMP
AU: OSSOFSKY-H-J [Author]
SO: Comprehensive-Psychiatry. 1976; 17(2): 335-346
PY: 1976
DT: Article
IS: 0010-440X
AB: To test the hypothesis that the affective state itself might be 
associated with atopic reaction, depressed children and adults 
referred for psychiatric evaluation between July 1972-July 1973 were 
referred for allergic evaluation irrespective of the presence of 
allergic signs or symptoms. Of 109 depressed patients evaluated, 93 
proved atopic. Of 3 nonatopic children, 2 developed positive skin 
reactions to testing, 4 and 8 mo. after being placed on imipramine 
therapy. Despite absence or paucity of allergic symptoms in about 
half of the atopic individuals, all 93 atopic patients were treated 
by routine techniques, including environmental control and 
desensitization. The affective disorder was treated concomitantly 
with imipramine HCl or, in a few adults, with desipramine HCl. As 
depression was relieved, several children developed allergic 
respiratory symptoms for the first time, despite immunotherapy. 
Allergic symptoms were relieved by increasing the strength of vaccine 
and/or decreasing the time interval between injections. The children 
showed frequent seasonal exacerbations of allergic symptoms 
independent of exacerbations of depression. Those receiving 
successful immunization seemed to respond considerably better than 
nonimmunized children; maintenance doses of imipramine tended to be 
significantly smaller and could be discontinued for longer intervals. 
The intimate relationship of allergy and depression suggested that an 
abnormality in a neurotransmitter and/or the hypothalamic 
pituitary-target-organ axis might be common to both clinical 
conditions. Hormonal functions mediated by the ATPase system 
(cyclic[c]AMP involvement in adrenal and thyroid hormonal systems) 
are discussed. A defect in cAMP, its precursors, its degradation 
products or its turnover probably accounts for the variation in 
steroid excretion patterns of depressed patients. The therapeutic 
effectiveness of compounds as dissimilar as thyroid hormone(s) and 
imipramine in the treatment of depression is discussed. Irritability 
and hyperactivity of the depressed child may be related to Ca and/or 
thyroid-provoked cAMP activity; enuresis and premenstrual fluid 
retention noted in some depressed children and adults are probably 
due to actions of Ca, aldosterone, angiotensin II and Na and K 
influences on the cAMP system. Several effects of cAMP dysfunction 
are discussed. Probing normal and abnormal cAMP activity may clarify 
the relationship between affective disorders and other illnesses such 
as ulcerative colitis, gastric and duodenal ulcers, rheumatoid 
arthritis, myasthenia gravis and migraine.