Circadian variations in plasma monoamine metabolites level in alcoholic patients: a possible predictor of alcohol withdrawal delirium.

1. Alcohol withdrawal symptoms in 17 alcoholics were classified into two groups according to the severity of their symptoms, and circadian variations in their plasma 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA) levels during the alcohol withdrawal and the abstention periods were compared with those in normal controls by two-way ANOVA. 2. Circadian variations in plasma 5HIAA level in alcoholic patients manifested severe alcohol withdrawal symptoms and exhibited phase advances in both the withdrawal and the abstention periods and significantly higher levels in the abstention period. 3. Circadian variation in plasma HVA in the abstention period in alcoholics showed severe withdrawal symptoms demonstrating significantly higher levels compared with normal controls. 4. These findings suggest that the serotonergic and dopaminergic activity may vary depending on the severity of alcohol withdrawal symptoms and the measurement of circadian variations in plasma 5HIAA and HVA levels could possibly be used as a predictor of hardly predictable alcohol withdrawal delirium.