The dopamine-serotonin relationship in clozapine response.
The effects of clozapine on the dopamine and serotonin systems may underlie its atypical pharmacologic and clinical profile. To examine this hypothesis, we measured dopamine and serotonin plasma and cerebrospinal (CSF) metabolites and the relationship of these values to treatment response in 19 neuroleptic refractory and intolerant schizophrenic patients. Only a small change in the CSF and plasma homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5HIAA) levels was found. However, the pretreatment CSF HVA/5HIAA ratio and, to a lesser extent, the CSF HVA level predicted treatment response. These results suggest that the modest relationship between HVA and 5-HIAA and treatment response supports the involvement of both neurotransmitters in the pathophysiology of schizophrenia.
Szymanski
S
S
Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.
Lieberman
J
J
Pollack
S
S
Munne
R
R
Safferman
A
A
Kane
J
J
Kronig
M
M
Cooper
T
T
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use*; D004298:Dopamine / Q000134:cerebrospinal fluid*; D004351:Drug Resistance; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000134:cerebrospinal fluid* / Q000188:drug therapy*; D012701:Serotonin / Q000134:cerebrospinal fluid*
D014150:Antipsychotic Agents; D012701:Serotonin; D006897:Hydroxyindoleacetic Acid; D003024:Clozapine; D004298:Dopamine; D006719:Homovanillic Acid