Molecular genetics and heterogeneity in manic depression

Recent research has shown that there are X-linked and possibly chromosome 11-linked forms of manic depression as well as at least one other autosomal form. Segregation analyses of large affected families and the finding of genetic linkage between chromosome specific markers and manic depression mutations provide strong evidence that bipolar as well as unipolar forms of manic depression (MD) within the same family are inherited as a dominant gene disorder. This clarification of the etiology of certain types of depression should bring changed attitudes within psychiatry and may serve to stimulate discussion of the role of evolutionary mechanisms. From a clinical point of view, it has now become possible to determine whether clinical (phenotypic) variation reflects the underlying genotypic heterogeneity of linkage. A preliminary analysis of data from four recent studies shows that there is no clear correlation between such clinical features as the ratio of unipolar to bipolar cases and the genotypic form of manic depression. Further recombinant DNA research, proven to be successful in other genetic diseases, can soon be applied to manic depression. The specific problems posed by manic depression for these techniques are discussed.     

A model for the dynamics of bipolar disorders

Bipolar disorders are characterized by recurrent, alternating episodes of mania and depression. To examine the dynamical bases of this cyclical illness we consider a minimal model for bipolar disorders based on the observation that the two poles of the disease are mutually exclusive. We assume that the propensities to mania and depression, which are correlated with the activity of two putative neural circuits that promote, respectively, the manic or the depressive state, inhibit each other. When mutual inhibition is sufficiently strong, the model predicts bistability: the bipolar system is then either in a depressive or in a manic state and can display abrupt switches between these stable states. We consider two simple mechanisms which, when added to mutual inhibition, allow the model to pass from bistability to oscillations. Self-sustained oscillations provide a mechanism for the spontaneous, recurrent switching between mania and depression. The model can generate oscillations with a variety of waveforms, including simple periodic oscillations with comparable or unequal durations of the manic and depressive episodes, or small-amplitude oscillations around one of the two states preceding large-amplitude periodic changes in the propensities to mania or depression. The model provides a theoretical framework that covers the bipolar spectrum, i.e., cycling between the two poles of the disease, or evolution to either mania or depression or to an intermediate state without alternating between the two poles of the disease. The model accounts for the clinical observation that antidepressants can trigger the transition to mania or increase the frequency of bipolar cycling.     

Predictors of the Onset of Manic Symptoms and a (Hypo)Manic Episode in Patients with Major Depressive Disorder

Objective

One third of patients with a major depressive episode also experience manic symptoms or, even, a (hypo)manic episode. Retrospective studies on the temporal sequencing of symptomatology suggest that the majority of these patients report depressive symptoms before the onset of manic symptoms. However, prospective studies are scarce and this study will, therefore, prospectively examine the onset of either manic symptoms or a (hypo)manic episode in patients with a major depressive disorder. In addition, we will consider the impact of a large set of potential risk factors on both outcomes.

Methodology

Four-year follow-up data were used to determine the onset of manic symptoms as well as a CIDI-based (hypo)manic episode in a large sample (n = 889, age: 18–65 years) of outpatients with a major depressive disorder and without manic symptoms at baseline. Baseline vulnerability (i.e., sociodemographics, family history of depression, childhood trauma, life-events) and clinical (i.e., isolated manic symptoms, depression characteristics, and psychiatric comorbidity) factors were considered as potential risk factors.

Results

In our sample of depressed patients, 15.9% developed manic symptoms and an additional 4.7% developed a (hypo)manic episode during four years. Baseline isolated manic symptoms and comorbid alcohol dependence predicted both the onset of manic symptoms and a (hypo)manic episode. Low education only predicted the onset of manic symptoms, whereas male gender, childhood trauma and severity of depressive symptoms showed strong associations with, especially, the onset of (hypo)manic episodes.

Conclusions

A substantial proportion (20.6%) of patients with a major depressive disorder later developed manic symptoms or a (hypo)manic episode. Interestingly, some identified risk factors differed for the two outcomes, which may indicate that pathways leading to the onset of manic symptoms or a (hypo)manic episode might be different. Our findings indirectly support a clinical staging model.     

Regulation of inositol monophosphatase in Saccharomyces cerevisiae

Inositol monophosphatase is a key enzyme in the de novo biosynthesis of inositol and in the phosphoinositide second-messenger signalling pathway. Inhibition of this enzyme is a proposed mechanism for lithium's pharmacological action in bipolar illness (manic depression). Very little is known about how expression of this enzyme is regulated. Because the yeast Saccharomyces cerevisiae has been shown to be an excellent model system in which to understand the regulation of inositol metabolism, we characterized inositol monophosphatase in this yeast. Lithium inhibited monophosphatase activity in vitro . Growth in the presence of inositol resulted in increased expression of the enzyme in vivo , although inositol had no effect on enzyme activity in vitro . The inositol effect was apparent when cells were grown in glucose but not in glycerol/ethanol. Monophosphatase activity was derepressed as cells entered stationary phase. This effect was apparent only during growth in glucose plus inositol. The results demonstrate that S. cerevisiae monophosphatase is inhibited by lithium and regulated by factors affecting phospholipid biosynthesis.     

Molecular mechanisms of leptin and pro-apoptotic signals induced by menadione in HepG2 cells

Apoptosis is a significant physiological function in the cell. P⁵³ is known as tumor suppressor cellular factor, executive caspases are also the most involved pathway for apoptosis. Menadione (VK3) has apoptotic action on many harmful cells, but the molecular role of adipokines is not studied enough in this regard, so the ability of menadione to modify the adipokine (leptin hormone), caspase-3 and P⁵³ signals to induce its apoptotic action on HepG2 cells was studied. The study revealed that menadione has anti-viability and apoptotic effect at sub-G1 phase of HepG2 cell cycle. Its cytotoxic effect is mediated by molecular mechanisms included: inhibiting leptin expression and level, activating caspase-3 pathway and up-regulating the expression of P⁵³. Menadione exerts its apoptotic mechanisms in a concentration and time dependent way through ROS generation. In addition to the known apoptotic pathways, the results indicate that suppressing leptin pathway is a significant mechanism for menadione apoptotic effect which made it as a potential therapeutic vitamin in preventing hepatocyte survival and proliferation.     

Peripheral profiling analysis for bipolar disorder reveals markers associated with reduced cell survival

Little is known about the molecular factors that are altered in remitting bipolar disorder (BD) patients. We carried out proteome profiling of peripheral blood mononuclear cells (PBMCs) and serum from BD patients who were not experiencing mania or major depression (euthymia) compared to matched healthy controls using liquid chromatography–mass spectrometry (LC‐MS^E) and Multi‐Analyte Profiling (Human Map^®) platforms. This resulted in the identification of approximately 60 differentially expressed molecules involved predominantly in cell death/survival pathways. In PBMCs, this was manifested in cytoskeletal and stress response‐associated proteins, whereas most serum analytes were associated with the inflammatory response. The predicted effect of serum analytes on physiological systems was tested by treating PBMCs with serum obtained from the same patients, resulting in reduced cellular survival. These preliminary results suggest that BD patients carry a peripheral fingerprint that has detrimental effects on cell function and that could be used to distinguish BD patients from healthy controls despite being in a remission phase. It is hoped that additional studies of BD patients in the manic and depressed stages could lead to the identification of a molecular fingerprint that could be used for predicting episodic switching and for guiding treatment strategies.     

Linkage analysis of the D1 dopamine receptor gene and manic depression in six families.

Disturbances in dopaminergic activity may play an important role in the pathogenesis of manic depression. The effects of dopamine are mediated by at least five G protein coupled receptors, D1, D2, D3, D4 and D5. Recently, three separate research groups have cloned and characterized the D1 dopamine receptor, which localizes to 5q35.1. We undertook a linkage analysis between the D1 receptor polymorphisms and manic depression in six families in which segregation of the disease was consistent with autosomal dominant inheritance. A highly polymorphic flanking DNA marker, CRI-L1200, was also analyzed as the D1 gene RFLPs were relatively uninformative in our families. Multipoint analyses of manic depression and these DNA markers resulted in lod scores of less than -3.0 at the D1 locus, indicating that the D1 dopamine receptor gene does not confer an inherited susceptibility to manic-depressive illness in the families studied.     

血清连蛋白、高迁移率族蛋白B1水平与双相障碍患者认知功能和肠道菌群相对丰度的相关性分析

摘要 目的：探讨血清连蛋白、高迁移率族蛋白B1（HMGB1）水平与双相障碍患者认知功能和肠道菌群相对丰度的相关性。方法：选取2018年5月～2021年5月北京回龙观医院收治的80例双相障碍患者,其中狂躁发作43例,抑郁发作37例,分别作为狂躁组、抑郁组,取同期于我院体检的健康志愿者62例作为对照组。比较三组血清连蛋白、HMGB1水平,并采用重复性成套神经心理状态测验（RBANS）评估三组认知功能。收集受试者的粪便标本,经聚合酶链反应（PCR）与测序技术分析肠道菌群相对丰度。利用Pearson线性相关检验分析血清连蛋白、HMGB1水平与RBANS评分及肠道菌群相对丰度的相关性。结果：狂躁组、抑郁组血清连蛋白、HMGB1水平高于对照组,即刻记忆、言语功能、注意、延时记忆、视觉广度评分及RBANS总分均低于对照组（P＜0.05）。狂躁组、抑郁组拟杆菌纲、拟杆菌目相对丰度均低于对照组,大肠埃希菌种相对丰度高于对照组,且狂躁组青春双歧杆菌相对丰度高于对照组、抑郁组,抑郁组青春双歧杆菌相对丰度低于对照组,抑郁组毛螺菌属相对丰度高于狂躁组与对照组（P＜0.05）。血清连蛋白与拟杆菌纲、拟杆菌目呈负相关,与大肠埃希菌种呈正相关（P＜0.05）,但与RBANS总分无相关性（P＞0.05）。血清HMGB1与RBANS总分、拟杆菌纲、拟杆菌目呈负相关,与大肠埃希菌种呈正相关（P＜0.05）。结论：双相障碍患者的血清连蛋白、HMGB1水平增高,其中连蛋白与患者认知功能异常无明显关联,而HMGB1与认知功能异常有关,且二者均会影响患者的肠道菌群变化。     

The Effects of Zinc on Contractility,Membrane Potentials,and Cation Content of Rat Atria

Zinc depresses the contractile force of electrically driven rat atria logarithmically with time. The threshold concentration is about 5 x 10^-6 M zinc and the half-time for contractile depression at 10^-4 M is about 25 minutes. Zinc also depresses spontaneous activity of atria and alters the transmembrane potential parameters in a manner similar to quinidine. Unlike quinidine, zinc causes an elevation of the resting potential and an elevation of cellular potassium which varies with time in the same way as the resting potential. Exposure to 10^-4 M zinc for 60 minutes causes a statistically significant fall in atrial calcium content and an amount of radioactively labeled zinc is taken up which is quantitatively equal to the calcium lost. Zinc has no effect on rigor caused by iodoacetate but inhibits rigor caused by 1-fluoro-2,4 dinitrobenzene. It is postulated that zinc depression of contractile force is not due to metabolic inhibition, probably not due to quinidine-like action on the cell membrane, but may be due to an interference in the handling of calcium by the cell.     

Action of La3+ on the systems providing contractility of vertebrate myocardium

The inotropic action of La³⁺ on frog myocardium was studied with taking into account its effect on mitochondria of cardiomyocytes (CM). It has been established that in the range of studied concentrations (0.2–6.0 mM), La³⁺ decreases dose-dependently the force of cardiac contractions (by 3.3–92.2%). In parallel experiments on isolated rat heart mitochondria (RHM), La³⁺ at a concentration of 25 μM has been shown to cause swelling of non-energized and energized mitochondria incubated in isotonic medium with 125 mM NH₄NO₃ and in hypotonic medium with 25 mM CH₃COOK. The study of oxidative processes in mitochondria with aid of polarographic method of measurement of oxygen concentration has shown that La³⁺ at concentrations of 50 and 100 μM increases the oxygen consumption rate by mitochondria in the state 2. However, La³⁺ does not decrease the respiration rate of isolated mitochondria in the state 3, as this takes place in the case of use of Cd²⁺ or at the Ca²⁺-overloading of mitochondria. The rate of endogenous respiration of isolated mitochondria in the medium with La³⁺ was higher than in control, which suggests its effect on ion permeability of the inner membrane. The data obtained in this work indicate that the La³⁺-produced decrease of contractility of cardiac muscle is not only due to the direct blocking effect on the potential-controlled Ca²⁺-channels, but is also mediated by its unspecific action on the CM mitochondria. This action is manifested as an acceleration of the energy-dependent K⁺ transport in matrix and as an increase of ion permeability of the inner mitochondrial membrane (IMM).     

THE COMPARATIVE EFFECT OF BUSULPHAN ('MYLERAN') AND AMINOCHLORAMBUCIL ON HAEMOPOIETIC COLONY FORMING UNITS IN THE RAT

Using the spleen colony assay technique, it has been shown that busulphan (‘Myleran’) in a dose of 10^-2 g/kg (1/2 LD₅₀), causes a marked and prolonged depression (over 90%) in the number of colony forming units per femur (CFU/femur). This depression is apparent before there is any marked reduction of the total cell count per femur and is maximal 2–4 days after an intraperitoneal (i.p.) injection of the drug. It is then followed by a steady recovery, normal values being reached after about 20 days. In contrast, aminochlorambucil (2·5 x 10^-3) g/kg = 1/2 LD⁵⁰) although producing a rapid fall in the marrow cellularity has no discernable effect on the CFU/femur. If, however, a depression of CFUs is first induced by busulphan and, after allowing time for 50% recovery (13 days), aminochlorambucil is now given, a further severe depression of the CFUs/femur occurs resulting in a considerable prolongation of the neutropenia observed in the blood. The possible implications of this in the mode of action of these two drugs, and in the chemotherapy of leukaemia, are discussed.     

Intracellular divalent cations and neuronal excitability.

Itracellular injections of Mg into cat spinal motoneurones have a depolarizing action, associated with a fall in input conductance, and depression of the postspike hyperpolarizing after-potential (a.h.p.) as well as its underlying conductance increase. There is also an increase in excitability, sometimes leading to outright discharge, and a change in the current-firing relation: the normal primary range is largely abolished and the firing appears to have the characteristics of the normal secondary range. Intracellular effects of Mg are thus mainly opposite to those of Ca, possibly owing to competition at sites where Ca activates K channels. Intracellular injections of Mn also tend to depress the a.h.p. but have relatively little effect on resting potential and conductance, or action potentials. Co also depresses the a.h.p. but has a more pronounced depolarizing action, and produces particularly strong depression of action potentials. By contrast intracellular Sr tends to raise the membrane conductance and has a mild hyperpolarizing effect. During the injection of Sr, a.h.p's are depressed but this is followed by a rebound of increased a.h.p. amplitude and conductance. Unlike the other divalent cations tested, Sr strongly depressed excitatory postsynaptic potentials. In most respects Sr appears to behave like Ca.     

Protective Effects of Paeoniflorin Against Glutamate-Induced Neurotoxicity in PC12 Cells via Antioxidant Mechanisms and Ca<Superscript>2+</Superscript> Antagonism

Preclinical and clinical investigations have shown hippocampal neuronal atrophy and destruction were observed in patients with depression, which could be ameliorated by the treatment with antidepressants. Therefore, neuroprotection has been proposed to be one of the acting mechanisms of antidepressant. Paeoniflorin, a monoterpene glycoside, has been reported to display antidepressant-like effects in animal models of behavioral despair. The present study aimed to examine the protective effect of paeoniflorin on glutamate-induced neurotoxicity in cultured rat pheochromocytoma (PC12) cells. The results showed that pretreatment with paeoniflorin elevated cell viability, inhibited apoptosis, decreased levels of intracellular reactive oxygen species and malondialdehyde, and enhanced activity of superoxide dismutase in glutamate-treated PC12 cells. Pretreatment with paeoniflorin also reversed the increased intracellular Ca²⁺ concentration and the reduced Calbindin-D28K mRNA level caused by glutamate in PC12 cells. The results suggest that paeoniflorin exerts a neuroprotective effect on glutamate-induced neurotoxicity in PC12 cells, at least in part, via inhibiting oxidative stress and Ca²⁺ overload. This neuroprotective effect may be one of the action pathways accounting for the in vivo antidepressant activity of paeoniflorin.     

Possible Involvement of PPAR-γ in the Anticonvulsant Effect of Aegle marmelos (L.) Correa

Aegle marmelos is well documented for antihyperglycemic effect and PPAR-γ activation has been suggested to be the molecular mechanism of its action. Also, the plant has been used in Ayurveda as a brain tonic and has been postulated to have antidepressant activities. The present study was designed to investigate the anticonvulsant effects of A. marmelos leaf extract (AME) in pentylenetetrazole and maximal electroshock induced convulsions; involvement of PPAR-γ, nitric oxide pathway and effect of chronic AME treatment on post-ictal depression. AME was administered at doses of 50, 100 and 200 mg kg^?1 in PTZ and MES model. Severity of convulsions was noted in both the models. Pretreatment with bisphenol A diglycidyl ether (BADGE) was used to study the involvement of PPAR-γ and l-arginine and N-nitro-l-arginine methyl ester hydrochloride (l-NAME) to study the involvement of nitric oxide (NO). Chronic treatment with AME interspersed with sub maximal doses of PTZ (50 mg kg^?1) on every fifth day up to 15 days was given to study post-ictal depression using forced swimming and actophotometer. AME showed significant increase in the onset time and decrease in the duration of convulsions in PTZ and MES models dose dependently. In MES a dose of 100 mg kg^?1 had effect comparable to phenytoin. Pretreatment with BADGE and l-arginine reversed the protective effect while l-NAME did not alter the protective effect, thereby indicating possible involvement of PPAR-γ and inhibition of NO. Chronic AME treatment ameliorated the post-seizure depression significantly as evidenced by increase in the locomotor activity and decrease in the immobility time.     

Effect of Insulin on Potassium Flux and Water and Electrolyte Content of Muscles from Normal and from Hypophysectomized Rats

It was reported previously that insulin hyperpolarized rat skeletal muscle and decreased K⁺ flux in both directions. The observations on K⁺ flux are now extended to take advantage of the greater sensitivity to insulin of hyperphysectomized rats. Insulin caused a shift of water from extracellular to intracellular space if glucose was present, but not in its absence. Insulin caused net gain of muscle fiber K⁺, though not necessarily an increase in K⁺ concentration in fiber water. It probably also decreased intrafiber Na⁺ and Cl^-. Insulin decreased K⁺ efflux. The effect was dose-dependent. Muscles from hypophysectomized rats were more sensitive to the action of insulin on K⁺ flux than were those from normal rats. The effect was demonstrable within the time resolution of the system, suggesting that insulin's action is on cell surfaces. K⁺ influx was also decreased by insulin. Bookkeeping suggests that some K⁺ influx be called active. Insulin seemed to decrease active K⁺ influx and passive K⁺ efflux. It is not resolved whether insulin has a true dual effect or whether it acts only on passive fluxes in both directions (the apparent action on active K⁺ influx being an artefact of incomplete definition of passive flux) or whether a single alteration in the membrane may affect both active and passive fluxes.     

Continuum of depressive and manic mixed states in patients with bipolar disorder: quantitative measurement and clinical features

Bipolar mixed states combine depressive and manic features, presenting diagnostic and treatment challenges and reflecting a severe form of the illness. DSM-IV criteria for a mixed state require combined depressive and manic syndromes, but a range of mixed states has been described clinically. A unified definition of mixed states would be valuable in understanding their diagnosis, mechanism and treatment implications. We investigated the manner in which depressive and manic features combine to produce a continuum of mixed states. In 88 subjects with bipolar disorder (DSM-IV), we evaluated symptoms and clinical characteristics, and compared depression-based, mania-based, and other published definitions of mixed states. We developed an index of the extent to which symptoms were mixed (Mixed State Index, MSI) and characterized its relationship to clinical state. Predominately manic and depressive mixed states using criteria from recent literature, as well as Kraepelinian mixed states, had similar symptoms and MSI scores. Anxiety correlated significantly with depression scores in manic subjects and with mania scores in depressed subjects. Discriminant function analysis associated mixed states with symptoms of hyperactivity and negative cognitions, but not subjective depressive or elevated mood. High MSI scores were associated with severe course of illness. For depressive or manic episodes, characteristics of mixed states emerged with two symptoms of the opposite polarity. This was a cross-sectional study. Mixed states appear to be a continuum. An index of the degree to which depressive and manic symptoms combine appears useful in identifying and characterizing mixed states. We propose a depressive or manic episode with three or more symptoms of the opposite polarity as a parsimonious definition of a mixed state.     

The effects of Mn2+ and Ca2+ on the prolonged depolarising after-potential in barnacle photoreceptor

We have studied the effects on the PDA of modifying intracellular and extracellular concentrations of Ca²⁺ and Mn²⁺. The effect of decreased Ca²⁺ concentration or addition of EGTA is mainly an increase in the PDA amplitude and length. Raising Ca²⁺ concentration using ruthenium red or high external Ca²⁺ has the opposite effect. The effect of Mn²⁺ is much more striking: In the presence of 50–100 mM Mn²⁺ the PDA is initially greatly depressed but can rise slowly for up to 20 or 30 s (in the dark) until it approaches its original amplitude and time course. Bridge measurements showed that the depression of the PDA corresponds to a depressed conductance and so is not due to an increase in K⁺ conductance. The Mn²⁺ effect is potentiated by decreased Ca²⁺. Appropriate stimulation suppresses the rising PDA as promptly as it does a normal PDA, suggesting that if lateral diffusion is the source of the slow rise, the PDA and PDA-depressing processes must be spatially linked. The action of the anti-PDA is apparently prolonged by both Ca²⁺ and Mn²⁺.Based on material presented at the European Neurosciences Meeting, Florence, September 1978     

Effect of platelet-activating factor (PAF) on sodium calcium exchange in cardiac sarcolemmal vesicles

Summary The effects of platelet-activating factor (PAF) on Na⁺-dependent calcium uptake in myocardial sarcolemmal vesicles were examined in order to clarify its mechanism of inotropic action on the heart. PAF (40 and 20 µM) significantly inhibited Na⁺-Ca²⁺ exchange by 61% and 37%, respectively. Both initial rate of exchange and maximal exchange were inhibited. The Km for the reaction was not altered but Vmax was lowered 55% by PAF. Lyso-PAF inhibited Na⁺-Ca²⁺ exchange to a similar degree as PAF. CV-3988, a specific PAF receptor antagonist, failed to diminish the inhibitory effect of PAF on Na⁺-Ca²⁺ exchange, suggesting that the effect of PAF on Na⁺-Ca ²⁺ exchange is not via a receptor mechanism. The passive permeability of sarcolemmal vesicles to Ca²⁺ was markedly elevated after PAF treatment. However, this effect could not account for the decrease in Na⁺-Ca²⁺ exchange. Interestingly, passive Ca²⁺ binding to cardiac sarcolemma was increased by 40 µM PAF. This study indicates that a depression of Na⁺-Ca²⁺ exchange probably does not play a role in the negative inotropic effect of PAF on the myocardium under physiological conditions. Its mechanism of action on Na⁺-Ca²⁺ exchange is discussed.     

Estradiol modulates the sodium pump in the heart sarcolemma

Cardiovascular effects of estrogens and particularly that of estradiol involve protection of the heart against ischemia. These effects were believed to be mainly indirect, mediated via changes in the blood and blood vessels. In the present paper a direct action of estradiol on the heart is demonstrated. Estradiol stimulates (p < 0.001) the Na,K-ATPase activity of cardiac sarcolemmal membranes by stimulating in an allosteric manner, the activation of the enzyme by potassium. The latter activation involves also an increase in affinity to potassium of the potassium binding sites on the enzyme molecule, but remains without any effect on the capacity and K_Dvalue of specific ouabain binding to the Na,K-ATPase. Estradiol is also antagonizing the depression of Na,K-ATPase activity that may be caused by ischemia and it is stimulating (p < 0.01) the ouabain-sensitive uptake of ⁸⁶Rb into the heart cells.Our results indicate, that in addition to the known indirect effects of estradiol on the heart, the hormone also stimulates the activity and improves the kinetics of interaction of cardiac sarcolemmal Na,K-ATPase with ATP as well as with Na⁺ and K⁺ ions. This direct action may also account for the cardioprotective effects of estradiol.     

Does guanabenz have a non-specific effect on spontaneous contractions of isolated guinea pig atria?

Guanabenz was found to produce a concentration-dependent depression of the isometric contractility of the isolated, spontaneously beating atria of the guinea-pig. It also depressed the atrial rate of the isolated, spontaneously beating atria of the guinea-pig. The effect of the increasing concentrations of guanabenz on the heart rate was weaker than its effect on the isometric contraction. A time-dependent depression of both the isometric contraction and of the atrial rate after the addition of a single dose of guanabenz was also found up to 10th min. Guanabenz did not change the maximal driving (following) frequency of the atria. Aminophylline partially, isoprenaline almost completely and calcium completely antagonized the negative inotropic action of guanabenz. They, however, did not antagonize the negative chronotropic action of guanabenz. It seems, regardless of what the precise mechanism(s) of action of guanabenz may be (probably nonspecific on the isolated guinea-pig atria), that all these substances (aminophylline, isoprenaline and calcium) restore the contractility of the isolated atria by compensating the calcium balance which has been previously changed by guanabenz.