Alcoholism and affective disorders frequently occur in the same individuals and in members of the same family. This association may represent the coexistence of two common disease entities due to chance or due to (a) alcoholism resulting from self-medication of an underlying affective disorder, or (b) depression resulting from toxic effects of alcohol abuse. Studies have shown that alcohol may acutely improve the sense of affective well-being, but with continued intoxication this improvement may be reversed. Also, during chronic experimental intoxication, alcoholics not only become increasingly depressed but also more anxious. In this protocol we propose to characterize certain biochemical aspects of depression and anxiety as they occur in alcoholic patients. To do this, we will examine cerebrospinal fluid and plasma for norepinephrine (lying and standing), urine for catecholamine metabolites and employ pharmacological challenge paradigms using lactate, isoproterenol and chlorimipramine.
