The article "Serotonin Receptors Offer Clue to Teen Suicide Risk" in the May 3 issue underscores the finding of increased serotonin-receptor density in the prefrontal cortex of teenage suicidal victims, as also occurs in adults. This is an important finding.

Neither the reporter nor Ghanshyam Pandey, Ph.D., however, hook this up with the established fact of lower levels of 5-hydroxy-indole acetic acid, a metabolic product of serotonin, in the cerebral spinal fluids of victims of violent suicide. An up-regulation of 5HT receptors would be expected in a serotonin deficit.

Other clinicians and I have discovered that specific serotonin reuptake inhibitor antidepressants often ameliorate both irritability and impulsivity in patients who may be exhibiting no other clinical signs of depression, including personality-disordered patients.

The findings of the study, therefore, bear important implications for treatment planning. One wonders, indeed, what might be the prefrontal 5HT receptor density in patients suffering from personality disorders. Might these disorders be, in part, adaptations to lifelong depressive disorder?