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July 1992

Urinary Excretion of Catecholamines and Their Metabolites in Relation to Circulating Catecholamines: Six-Hour Infusion of Epinephrine and Norepinephrine in Healthy Volunteers

Author Affiliations

From the Departments of Psychiatry (Dr Moleman and Mr Tulen) and Internal Medicine (Drs Blankestijn, Man in 't Veld, and Boomsma), University Hospital Rotterdam-Dijkzigt and the Medical Faculty of Erasmus University Rotterdam (the Netherlands), and Moleman Research, Rotterdam (Dr Moleman).

Arch Gen Psychiatry. 1992;49(7):568-572. doi:10.1001/archpsyc.1992.01820070062009

• Some depressed patients have been shown to excrete abnormal amounts of catecholamines and their metabolites in urine. Some studies suggest that hypersecretion of epinephrine by the adrenals and of norepinephrine by the peripheral sympathetic system cause increased excretion of urinary catecholamines and their metabolites in a subgroup of patients. To evaluate the effect of increased catecholamine levels in the peripheral circulation on urinary catecholamine and metabolite levels, we infused healthy volunteers during 6 hours with epinephrine, norepinephrine, or placebo, respectively, in a three-period, double-blind, crossover design. The results indicate that (1) urinary epinephrine and norepinephrine levels were the most sensitive indicators of increased circulating epinephrine and norepinephrine levels, respectively; (2) changes in circulating epinephrine or norepinephrine levels were not readily reflected in changes in urinary vanillylmandelic acid or 3-methoxy-4-hydroxyphenylglycol levels; and (3) increased normetanephrine excretion was not only induced by infusion of norepinephrine but also by epinephrine. This last finding may be due to activation of the sympathetic nervous system by circulating epinephrine. These results may help to explain the mechanism of adrenal epinephrine and sympathetic nervous system norepinephrine hypersecretion observed in subgroups of depressed patients.

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