Alcoholism and affective disorders frequently occur in the same individuals and in members of the same family. This association may represent the co-existence 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 consequences 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 intoxication, alcoholics not only become increasingly depressed but also more anxious. In this protocol, certain biochemical aspects of depression and anxiety are characterized as they are manifested in alcoholic patients. Cerebrospinal fluid and plasma are analyzed for norepinephrine (lying and standing), urine for catecholamine metabolites and pharmacological challenge paradigms using lactate, isoproterenol and chlorimipramine are employed. Results indicate that alcoholics with panic disorder have a number of distinguishing biological characteristics: (1) alcoholics with panic have a reduced response to lactate administration compared to panic patients without alcoholism; (2) higher CSF B-endorphin charateristics compared to controls and (3) a heightened affective response to chlorimipramine compared with alcoholics and controls.
