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December 1969

Catecholamine Metabolism in Affective Disorders: II. Norepinephrine, Normetanephrine, Epinephrine, Metanephrine, and VMA Excretion in Hypomanic Patients

Author Affiliations

Bethesda, Md
From the Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Md. Dr. Greenspan is now at the New York State Psychiatric Institute, New York. Dr. Schildkraut is now at the Neuropsychopharmacology Laboratory, Massachusetts Mental Health Center and the Department of Psychiatry, Harvard Medical School, Boston. Dr. Levy is now at the Massachusetts General Hospital, Department of Psychiatry, Boston. Dr. Durell is now at The Psychiatric Institute, Washington, DC.

Arch Gen Psychiatry. 1969;21(6):710-716. doi:10.1001/archpsyc.1969.01740240070009

THE FAIRLY consistent correlation between the clinical effects of drugs used in the treatment of manic-depressive disorders and the alterations in the metabolism of biogenic amines (particularly norepinephrine and serotonin) produced by these drugs has stimulated the investigation of catecholamine and indoleamine metabolism in patients with affective disorders.1-4 Direct assay of monoamine metabolism in the central nervous system in man is, of course, not feasible and most studies have examined the urinary excretion of the various biogenic amines or one or another of their metabolites.

The investigation of catecholamine metabolism in affective disorders has been of particular interest to us. The literature on studies in depressed patients has recently been reviewed.5 Changes in catecholamine metabolism in hypomanic patients have been studied less extensively. Urinary excretion of norepinephrine and epinephrine has been found to be greater during periods of mania

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