Changes of Plasma Homovanillic Acid in Neuroleptic Responsive and Non-responsive Schizophrenics / 신경정신의학

OBJECTIVES: Changes in plasma homovanillic acid(HVA) were investigated in neuroleptic responsive and non-responsive schizophrenics in order to delineate parameters of dopamine regulation, which may underlie differences in neuroleptic responsivity. METHOD: Twenty newly admitted acute schizophrenic patients were treated with haloperidol for 6 weeks. HVA was sampled at baseline, 3 days after initial neuroleptic dose, and after 1, 2, 3, 4, 6 weeks of treatment. Nine patients were classified as responders in this prospective haloperidol treatment trial. They had a score of change in the BPRS total scores of 25% or greater. Eleven patients were classified as nonresponders, based on a score of changes in the BPRS total scores of less than 25%. RESULTS: 1) The age of onset in respnder was older than nonresponder. 2) There were no significant changes in plasma HVA levels in total patients during 6 weeks haloperidol treatment period, but the nonreponders had a robust decrease in HVA level from baseline to 3 days and one week after haloperidol treatment in successive comparison. 3) There were no significant correlations between plasma HVA level and total scores of BPRS. CONCLUSIONS:This study suggested that neuroleptic non-responsive schizophrenics had a different plasma HVA concentration during haloperidol treatment but could not provide support to the idea that change in plasma HVA in response to neuroleptics can predict eventual clinical response to treatment. Further study is required in order to better characterize the changes in dopamine turnover in subgroups of schizophrenics.

Relationship between Therapeutic Response and Plasma HVA/5-HIAA Ratio in Newly Admitted Schizophrenia / 대한정신약물학회지

Twenty newly admitted acute schizophrenic patients were treated with haloperidol for 6 weeks. HVA and 5-HIAA were sampled at baseline, 3days after initial neuroleptic dose, and after 1, 2, 3, 4, 6 weeks of treatment. Nine patients were classified as responders in this prospective haloperidol treatment trial. They had a score of change in the BPRS total scores of 25% or greater. Eleven patients were classified as nonresponders, based on a score of changes in the BPRS total scores of less than 25%. 1) There was no significant difference in plasma HVA/5-HIAA ratio between responder and non-responder before and after haloperidol treatment. 2) There was no significant correlations between plasma HVA/5-HIAA ratio and BPRS total scores. This study could not support the hypothesis that neuroleptic treatment would be effective by changing dopamine and serotonin function and/or by altering their interaction.