Neurotransmitter-based diagnosis and treatment: A hypothesis (Part 2)

Commentary There is a need to connect mental and physical symptoms in the diagnosis and treatment of psychiatric disorders.Obviously, we are not yet equipped to clearly recognize which neurotransmitters cause which symptoms.The science of defining the underlying mechanisms is lagging behind the clinical needs.However, in this article, we present a few hypo thetical clinical cases to emphasize a possible way of analyz ing symptoms in order to identify underlying pathology and guide more effective treatment.Our descriptions do not reflect the entire set of symptoms caused by these neurotransmitters; we created them based on what is presently known (or sus pected).Additional research is needed to confirm or disprove the hypotheses we present.In Part 1 (Current Psychiatry, May 2022), we argued that for depression, anxiety, psychosis, and bipolar disor der, development and approval of medications is currently based on descriptive diagnoses, with disregard to the vari ous underlying causes of those conditions.Similar to how the many types of pneumonia are treated differently based on the specific infective agent, we suggested there are various types of depression or chronic pain based on the underlying neuro transmitter pathology.Such an approach may be extrapolated to anxiety, psychosis, or bipolar disorder, although those conditions are outside the scope of this article.In Part 1, we described serotonin and dopamineassociated mental and physical symptoms that suggest distinctly different types of depression or chronic pain, and we suggested specific ways Neurotransmitter-based diagnosis and treatment: A hypothesis (Part 2)Recognizing symptoms associated with endorphin and norepinephrine dysfunction SCIEPRO/SHUTTERSTOCK DisclosuresThe authors report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.