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May 1960

Carbohydrate Metabolism in Brain Disease: XIII. Effect of Lactate Infusion on Blood Keto-Acid Concentrations in Schizophrenic and Manic-Depressive Psychoses

AMA Arch Intern Med. 1960;105(5):752-754. doi:10.1001/archinte.1960.00270170090010

Introduction  Earlier communications from this laboratory reported abnormalities in carbohydrate metabolism in various psychotic states.1,2 Among the most important of the changes noted in patients was an excessive rise in lactate and pyruvate after ingestion of glucose or fructose; similar changes in α-ketoglutarate and citrate have also been observed.Since it seemed possible that excessive rises of lactate and pyruvate observed after ingestion of glucose in psychotic patients might also be reflected in abnormal utilization of lactate itself, studies with intravenous lactate were undertaken. Preliminary work,3 in fact, had suggested that lactate was removed somewhat more slowly by psychotic patients and further examination of this phenomenon was in order.

Materials and Methods  A total of 17 patients and 8 control subjects were studied. There were eight acutely psychotic patients, and nine chronically psychotic patients, five of whom had been lobotomized. All patients were schizophrenic, except for two patients