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February 1990

Norepinephrine in Acute Exacerbations of Chronic Schizophrenia: Negative Symptoms Revisited

Author Affiliations

From the Western Psychiatric Institute and Clinic, University of Pittsburgh (Pa) Medical School, and Highland Drive Veterans Administration Medical Center, Pittsburgh (Drs D. P. van Kammen, Peters, Yao, W. B. van Kammen, Neylan, and Shaw); and the National Institute of Alcoholism and Alcohol Abuse, Bethesda, Md (Dr Linnoila).

Arch Gen Psychiatry. 1990;47(2):161-168. doi:10.1001/archpsyc.1990.01810140061009

• In recent years the dopamine hypothesis has failed to explain the complexities of schizophrenia. Because both negative symptoms and noradrenergic activity appear to increase with psychotic relapse, we studied negative symptoms, psychosis, cerbrospinal fluid norepinephrine, and cerebrospinal fluid monoamine metabolites in 32 male patients with a DSM-III diagnosis of schizophrenia while both receiving and not receiving long-term haloperidol treatment. Drug-free cerebrospinal fluid norepinephrine and 3-methoxy-4-hydroxyphenylglycol levels correlated significantly with the severity of negative symptoms and psychosis ratings. When the patients were divided into those who did and did not relapse while not receiving the drug, significant positive correlations between negative symptoms and cerebrospinal fluid norepinephrine and 3-methoxy-4-hydroxyphenylglycol were observed only in the patients who relapsed. Nonsignificant but negative correlations were observed between the same variables in the nonrelapsers. Thus, increased norepinephrine activity in drug-free patients is associated with intensification of schizophrenic symptoms without necessarily causing the symptoms.

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