CHANGES IN URINARY MONOAMINE METABOLITES WITH ANTIPSYCHOTIC TREATMENT IN SCHIZOPHRENIA
Objective: Monoamine neurotransmitters have been considered important mediators of schizophrenia pathology and antipsychotic drug action. This
study examines the level of monoamine metabolites, homovanillic acid (HVA), 5-hydroxy indole acetic acid (5-HIAA), and vanillylmandelic acid (VMA),
monoamine metabolites of major neurotransmitters dopamine, serotonin and norepinephrine, respectively in urine of patients with schizophrenia as
compared to normal controls and the change in monoamine metabolites with antipsychotic treatment.
Methods: Thirty-four drug-free patients with schizophrenia diagnosed with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition
(DSM-IV) criteria and 15 normal controls were taken for the study. Patients were assessed for psychopathology using positive and negative syndrome
scale (PANSS) scale at baseline and 4 weeks after the treatment. Urinary monoamine metabolites (HVA, 5-HIAA, and VMA) were measured before and
after 4 weeks of treatment using high-performance liquid chromatography.
Results: There was a trend toward higher levels of HVA and VMA in the patients as compared to controls. There was a trend toward reduction in 5-HIAA
levels with treatment in patients with schizophrenia. No correlation was found between the levels of monoamine metabolites and psychopathology.
Significant positive correlation was found between 5-HIAA with VMA and HVA.
Conclusion: The present study indicates that noninvasive measurement of monoamine metabolites in urine may be of value in differentiating patients
with schizophrenia from controls.
Keywords: Monoamine, Homovanillic acid, 5-Hydroxy indole acetic acid, Vanillyl mandelic acid, Schizophrenia.
2. van Kammen DP, Peters J, Yao J, van Kammen WB, Neylan T, Shaw D, et al. Norepinephrine in acute exacerbations of chronic schizophrenia. Negative symptoms revisited. Arch Gen Psychiatry 1990; 47: 161-8.
3. Vollenweider FX. Advances and pathophysiological models of hallucinogenic drug actions in humans: a preamble to schizophrenia research. Pharmacopsychiatry 1998; 31: 92-103.
4. Mathieu P, Lemoine P, Szestak M, Greffe J, Gros N, Echassoux C. Homovanillic acid (HVA) urinary excretion and day/night rhythm of chronic schizophrenic patients. Preliminary observations. Encephale 1985; 11: 199-202.
5. Markianos M, Tripodianakis J, Garelis E. Neurochemical studies on tardive dyskinesia. II. Urinary methoxyhydroxyphenylglycol and plasma dopamine-beta-hydroxylase. Biol Psychiatry 1983; 18: 347-54.
6. Kemali D, Del Vecchio M, Maj M. Increased noradrenaline levels in CSF and plasma of schizophrenic patients. Biol Psychiatry 1982; 17: 711-7.
7. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale for schizophrenia. Schizophr Bull 1987; 13: 261-76.
8. Davis KL, Davidson M, Mohs RC, Kendler KS, Davis BM, Johns CA, et al. Plasma homovanillic acid concentration and the severity of schizophrenic illness. Science 1985; 227: 1601-2.
9. Chang WH, Chen TY, Lee CF, Hung JC, Hu WH, Yeh EK. Plasma homovanillic acid levels and subtyping of schizophrenia. Psychiatry Res 1988; 23: 239-44.
10. Baeza I, Castro-Fornieles J, Deulofeu R, de la Serna E, Goti J, SalvÃ J, et al. Plasma homovanillic acid differences in clinical subgroups of first episode schizophrenic patients. Psychiatry Res 2009; 168: 110-8.
11. Gershan S, Shopsin B, Wilk S. Urinary MHPG in schizophrenic population. Neuropsychobiology 1976; 2: 145-60.
12. Barbeito L, Lista A, Silveira R, Dajas F. Resting urinary catecholamine excretion in schizophrenics: methodology and interpretation of results. Biol Psychiatry 1984; 19: 1419-25.
13. Tuckwell HC, Koziol JA. On the concentration of 5-hydroxyindoleacetic acid in schizophrenia: a meta-analysis. Psychiatry Res 1996; 59: 239-44.
14. Crowley TJ, Hoehn MM, Rutledge CO, Stallings MA, Heaton RK, Sundell S, et al. Dopamine excretion and vulnerability to drug-induced Parkinsonism in schizophrenic patients. Arch Gen Psychiatry 1978; 35: 97-104.
15. Koreen AR, Lieberman J, Alvir J, Mayerhoff D, Loebel A, Chakos M, et al. Plasma homovanillic acid levels in first-episode schizophrenia. Psychopathology and treatment response. Arch Gen Psychiatry 1994; 51: 132-8.
16. Zhang ZJ, Peet M, Ramchand CN, Shah S, Reynolds GP. Plasma homovanillic acid in untreated schizophrenia--relationship with symptomatology and sex. J Psychiatr Res 2001; 35: 23-8.
17. Javaid JI, Sharma RP, Janicak PG, Davis JM. Plasma HVA in psychiatric patients: longitudinal studies. Psychopharmacol Bull 1990; 26: 361-5.
18. Akiyama K, Tsuchida K, Kanzaki A, Ujike H, Hamamura T, Kondo K, et al. Plasma homovanillic acid levels and therapeutic outcome in schizophrenics: comparisons of neuroleptic-naive first-episode patients and patients with disease exacerbation due to neuroleptic discontinuance. Biol Psychiatry 1995; 38: 639-48.
19. Chang WH, Hwu HG, Chen TY, Lin SK, Lung FW, Chen H, et al. Plasma homovanillic acid and treatment response in a large group of schizophrenic patients. Schizophr Res 1993; 10: 259-65.
20. Agren H, Mefford IN, Rudorfer MV, Linnoila M, Potter WZ. Interacting neurotransmitters system: a non-experimental approach to the 5HIAA-HVA correlation in human CSF. J Psychiatr Res 1986; 20: 175-93.
21. LindstrÃ¶m LH. Low HVA and normal 5HIAA CSF levels in drug free schizophrenic patients compared to healthy volunteers: Correlations to symptomatology and family history. Psychiatry Res 1985; 14: 265-73.
22. Contreras SA, Maas JW, Seleshi E, Bowden CL. Increase in human urine homovanillic acid concentration after neuroleptic treatment is the same with or without debrisoquin administration. Arch Gen Psychiatry 1987; 44: 1109-10.
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