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Serotonin is a key neurotransmitter in the central nervous system. In recent years its role in the pathophysiology and pharmacology of depression has been extensively investigated. Neuroendocrine studies suggest decreased serotonergic responsivity in patients with major depression. The fact that the majority of patients become depressed in a setting of stressful life events may indicate that the neurotransmitter disturbance occurs as part of the stress response in certain vulnerable individuals. Effective treatment of depression results in normalization of this disturbance. Drugs which selectively block the reuptake of serotonin are effective antidepressants with a low incidence of side effects.

Three cases of vascular crises associated with the use of MAOIs and the ingestion of alcohol-free beer are reported.

Thirty healthy subjects 12 males and 18 females were given the acetylcholinesterase inhibitor pyridostigmine (120 mg) orally. The growth hormone (GH) response was measured as the maximum GH level post-pyridostigmine relative to baseline. Twenty-six subjects increased their GH level in response to pyridostigmine. Responses in females were considerably greater than those in males and correlated closely with serum oestradiol levels. Overall there was a significant negative correlation between GH response and age.

Prolactin response to buspirone challenge was examined in eight normal healthy male and six healthy female volunteers. A significant increase in prolactin levels was noted around 90 min following oral administration of buspirone hydrochloride. When subjects were tested on two further occasions it was found that responses in males were consistently reproducible while responses in females varied throughout the menstrual cycle with maximum responses occurring premenstrually. It is postulated that increased sensitivity of the 5HT receptor premenstrually may explain the variability in females.

Six bipolar patients in a manic episode were treated with the calcium antagonist verapamil. A decrease in the level of psychopathology was noted in 5 of the 6, though there was a tendency for patients to relapse in the third week of treatment. Cortisol levels decreased steadily with clinical improvement while growth hormone levels tended to rise. In contrast to traditional antipsychotics verapamil did not alter prolactin levels. Its neuroendocrine profile suggests its therapeutic effects are not mediated by dopamine receptor blockade.