Perspectives in the treatment of the psychoneurological disorders: affective disorders

1. Current research strategies in the pharmacotherapy of the affective disorders are reviewed in an attempt to highlight major trends and areas of particular promise. 2. There has been some progress toward the identification of biologically defined subgroups by assessing amine metabolites in urine or cerebrospinal fluid which may lead to a more rational choice of therapies for depressed patients. 3. The use of drugs with receptor agonist properties may help define biological substrates altered in affective illness and lead to new approaches to treatment, such as utilization of low doses of receptor agonists which may preferentially stimulate presynaptic receptors. 4. Study of time-dependent and adaptive changes in receptor sensitivity may also add an important perspective in conceptualizing the cyclic process in manic-depressive illness and its treatment.