Norepinephrine in acute exacerbations of chronic schizophrenia. Negative symptoms revisited.
In recent years the dopamine hypothesis has failed to explain the complexities of schizophrenia. Because both negative symptoms and noradrenergic activity appear to increase with psychotic relapse, we studied negative symptoms, psychosis, cerebrospinal fluid norepinephrine, and cerebrospinal fluid monoamine metabolites in 32 male patients with a DSM-III diagnosis of schizophrenia while both receiving and not receiving long-term haloperidol treatment. Drug-free cerebrospinal fluid norepinephrine and 3-methoxy-4-hydroxyphenylglycol levels correlated significantly with the severity of negative symptoms and psychosis ratings. When the patients were divided into those who did and did not relapse while not receiving the drug, significant positive correlations between negative symptoms and cerebrospinal fluid norepinephrine and 3-methoxy-4-hydroxyphenylglycol were observed only in the patients who relapsed. Non significant but negative correlations were observed between the same variables in the nonrelapsers. Thus, increased norepinephrine activity in drug-free patients is associated with intensification of schizophrenic symptoms without necessarily causing the symptoms.
Western Psychiatric Institute and Clinic, University of Pittisburgh, Pa Medical School.
D P
DP
van Kammen
J
J
Peters
J
J
Yao
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WB
van Kammen
T
T
Neylan
D
D
Shaw
M
M
Linnoila
D000208:Acute Disease; D000328:Adult; D006220:Haloperidol / Q000627:therapeutic use; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D009638:Norepinephrine / Q000134:cerebrospinal fluid*; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012559:Schizophrenia / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D012565:Schizophrenic Psychology
D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D006220:Haloperidol; D009638:Norepinephrine; D006719:Homovanillic Acid