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Lithium Carbonate and Plasma Cortisol Response in the Affective Disorders

Stanley R. Platman, MD, MB. MRCP; Ronald R. Fieve, MD
Arch Gen Psychiatry. 1968;18(5):591-594. doi:10.1001/archpsyc.1968.01740050079013.
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DISTURBED, retarded, and severely depressed patients appear to have higher morning plasma cortisol levels than normal control populations.1-3 Hyperactive manic patients have been found to have normal or low levels of morning plasma cortisol.3,4 However, most cortisol values, in these reported cases, do not fall outside the normal range, and patients with obviously abnormal results may show evidence of malnutrition or previous poor dietary history.

At no time has any specific association been found between affective disorders and cortisol metabolism. It does seem that stress or discomfort-involvement increase plasma cortisol, while calm, sleep or hypnosis5 reduce it to very low levels.

In a longitudinal study of manic-depressive disorder, we tested the three following hypotheses:

1. Patients with affective disorders have an abnormal diurnal pattern of behavior. Diurnal plasma cortisol levels were tested for possible correlated changes. Recently, several authors have investigated plasma


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