Longitudinal changes in symptoms and plasma homovanillic acid levels in chronically medicated schizophrenic patients

Suzuki, Emiko; Kanba, Shigenobu; Nibuya, Masashi; Adachi, Sunao; Sekiya, Utako; Shintani, Futoshi; Kinoshita, Norihasa; Yagi, Gohei

doi:10.1016/0006-3223(94)91174-6

Cited by 14 publications

(5 citation statements)

References 46 publications

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“…Symptomatic improvement and reaching remission status was most pronounced in FEP patients, as repeatedly reported by other investigators [10,32]. These observations may be related with the individual's state of neuroplasticity, as reflected by the ability to alter pHVA levels, especially since lack of plasticity is hypothesized to be related with loss of antipsychotic efficacy [33,34], poor prognosis and chronic course of disease [12,35].…”

Section: Discussionsupporting

confidence: 62%

“…Low pHVA levels have been associated with deficit states [8], whereas high baseline pHVA levels have been reported to be related with improvement of positive psychotic symptoms after treatment with antipsychotics [9]. Elevated pHVA levels have been shown to be correlated with severity of psychotic symptoms during acute relapse [10] and appeared to be present already in the prodromal phase of schizophrenia [11]. Furthermore, some authors have reported differences in pHVA between patients with first-episode psychosis (FEP) and those with relapsing or chronic psychoses, calling for further investigation [12].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Plasma Homovanillic Acid and Outcome in Patients with Psychosis Spectrum Disorders

Kerkhof

Fekkes²,

Heijden³

et al. 2015

Neuropsychobiology

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Background: Psychosis spectrum disorders, especially schizophrenia, have been linked to disturbed dopaminergic activity in the brain. Plasma homovanillic acid (pHVA) levels partly represent dopaminergic metabolism in the central nervous system. In the present study associations between (changes in) pHVA levels, symptom severity and symptomatic improvement in patients with psychoses were investigated. Methods: From a total of 80 patients, 58 fulfilled all inclusion criteria and their symptom profile and severity were assessed by means of the Comprehensive Assessment of Symptoms and History (CASH), the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale for Severity and Improvement (CGI-S/CGI-I) at baseline and after 6 weeks of antipsychotic treatment. After inclusion, all patients were prescribed first- or second-generation antipsychotics by their treating psychiatrist. A total of 12 patients had first-episode psychosis (FEP). At both time points, pHVA levels were measured. Subsequently, pHVA levels were compared with an age-matched control sample and changes in pHVA levels (ΔpHVA) after treatment were associated with clinical parameters. Results: Before analyses, data were scrutinized for possible confounders, particularly gender, smoking, medication status (including antipsychotic class), and recent drug use. The pHVA levels in patients were not different from those in controls. Treatment resulted in a significant decrease of all parameters. Symptomatic improvement as well as ΔpHVA was most pronounced in FEP patients. Conclusion: These findings show that patients with FEP have a more favourable outcome than non-FEP patients and that greater ΔpHVA also suggests that FEP patients still have the capacity to adjust dopaminergic neurotransmission.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Relationship between Plasma Homovanillic Acid and Outcome in Patients with Psychosis Spectrum Disorders

Kerkhof

Fekkes²,

Heijden³

et al. 2015

Neuropsychobiology

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“…Thus, a vast number of studies have been conducted to relate pHVA levels with some aspects of such mental disorders as schizophrenia. For example, the ability of pHVA levels to predict response to treatment with typical (Chang et al 1993;Davilia et al 1988;Davis et al 1985;Pickar et al 1984;Suzuki et al 1994) and atypical (Green et al 1993;Sumiyoshi et al 1997a) neuroleptics has been tested in subjects with schizophrenia.…”

mentioning

confidence: 99%

Effect of Mental Stress on Plasma Homovanillic Acid in Healthy Human Subjects

Sumiyoshi

Yotsutsuji

Kurachi

et al. 1998

Neuropsychopharmacology

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“…Associations between pHVA and several mental domains have already been reported in different psychiatric diseases. A large body of clinical research has linked altered pHVA levels with psychotic states, 28 symptom severity, 85 , 86 negative symptoms, and anhedonia, 87 , 88 as well as the occurrence of relapse of psychotic symptoms 89 in schizophrenia. Furthermore, correlations between pHVA concentrations and psychotic symptoms have also been observed in delirium 90 and Alzheimer’s disease.…”

Section: Discussionmentioning

confidence: 99%

Antidopaminergic medication in healthy subjects provokes subjective and objective mental impairments tightly correlated with perturbation of biogenic monoamine metabolism and prolactin secretion

Veselinović

Vernaleken

Cumming

et al. 2018

NDT

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ObjectivesOff-label prescription of antipsychotics to patients without psychotic symptoms has become a routine matter for many psychiatrists and also some general practitioners. Nonetheless, little is known about the possibly detrimental effects of antidopaminergic medications on general psychopathology, subjective mental state, or a possible association with physiological parameters in nonpsychotic individuals.MethodsIn this randomized, single-blinded study, groups of healthy volunteers (n=18) received low doses of reserpine, aripiprazole, haloperidol, or placebo on 7 successive days. Relevant physiological parameters (plasma prolactin, concentrations of catecholamine metabolites in plasma, and 24-hour urine) and each subject’s mental state (Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression, visual analogue scale, Beck Depression Inventory II) were assessed at the start and end of the trial.ResultsOf the three active treatments, only reserpine caused a significant increase in some plasma- and urine-catecholamine metabolites, but all three medications evoked objective and subjective changes in general psychopathology scores, which correlated with individual increases in plasma homovanillic acid concentrations. Both objective and subjective impairments were significantly more pronounced in the subgroup with greatest increase of plasma prolactin. Subjects experiencing the most pronounced side effects under haloperidol, which compelled them to drop out, showed significantly higher prolactin concentration increases than those who tolerated haloperidol well.ConclusionWe found consistent associations between altered markers of dopamine transmission and several objective and subjective mental impairments in healthy volunteers after 1 week’s treatment with antidopaminergic medications. These findings should draw attention to a more intensive risk–benefit evaluation in cases of off-label prescription of antipsychotic medications.

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Longitudinal changes in symptoms and plasma homovanillic acid levels in chronically medicated schizophrenic patients

Cited by 14 publications

References 46 publications

Relationship between Plasma Homovanillic Acid and Outcome in Patients with Psychosis Spectrum Disorders

Relationship between Plasma Homovanillic Acid and Outcome in Patients with Psychosis Spectrum Disorders

Effect of Mental Stress on Plasma Homovanillic Acid in Healthy Human Subjects

Antidopaminergic medication in healthy subjects provokes subjective and objective mental impairments tightly correlated with perturbation of biogenic monoamine metabolism and prolactin secretion

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