The National Institute of Mental Health (NIMH), both separately and together with the National Naval Medical Center, is studying central amine metabolites in the cerebrospinal fluid (CSF) of psychiatric patients. Results to date indicate that aggression and anti-social behavior are inversely correlated with CSF 5-hydroxyindoleacetic acid (5HIAA). Low CSF 5HIAA is also associated with suicidal history; suicidal history is similarly associated with a history of aggressive, anti-social behavior. Thus, a trivariate relationship exists between history of aggression, history of suicidal behavior, and lower CSF 5HIAA. Findings have been largely replicated in two separate populations. Alcoholics have decreased CSF 5HIAA during abstinence. Disulfiram (Antabuse) appears to lower CSF homovanillic acid (HVA) and appears to increase serum norepinephrine (NE); low CSF dopamine-beta-hydroxylase (DBH), low platelet monoamine oxidase (MAO), low plasma amine oxidase (AO), and high red-cell catechol-O-methyl transferase (COMT) are related to adverse reactions to disulfiram. CSF DBH is inversely related to significant deviations in certain personality measures on the MMPI; CSF 5HIAA is inversely related to the Pd scale. Depressive ratings in alcoholics do not respond to disulfiram; depressive and aggressive affect are inversely related in alcoholics.
