Plasma homovanillic acid and treatment response in a large group of schizophrenic patients.
Plasma levels of homovanillic acid (pHVA), a metabolite of dopamine, were measured in ninety-five Chinese schizophrenic patients free of neuroleptics for at least four weeks. These patients were treated with classical antipsychotics for six weeks. Pretreatment pHVA was positively correlated with the subsequent clinical response (r = 0.408, p < 0.0001). Good responders (BPRS improvement > or = 50%, n = 47) had higher pretreatment pHVA levels than poor responders (BPRS improvement < 50%, n = 48) (15.7 +/- 8.4 ng/ml versus 9.9 +/- 3.7 ng/ml, p < 0.0001). A higher than 15 ng/ml pretreatment pHVA level was associated with a more consistent clinical response to the subsequent treatment. Using a pHVA level of 12 ng/ml as a demarcation point, 72% of patients (34 of 47) who had pHVA > or = 12 responded whereas 65% (31 of 48) who had < 12 did not respond (chi-square = 13.02, p < 0.0001). These results suggest that higher pretreatment pHVA levels may predict a better clinical response to antipsychotics. Based upon the pHVA findings, two hypothetical subtypes of schizophrenia are proposed.
Chang
W H
WH
Laboratory of Biological Psychiatry, Taipei City Psychiatric Center, Taiwan, ROC.
Hwu
H G
HG
Chen
T Y
TY
Lin
S K
SK
Lung
F W
FW
Chen
H
H
Lin
W L
WL
Hu
W H
WH
Lin
H N
HN
Chien
C P
CP
D000293:Adolescent; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005475:Flupenthixol / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006220:Haloperidol / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006719:Homovanillic Acid / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D005475:Flupenthixol; D006220:Haloperidol; D006719:Homovanillic Acid