Szymanski S, Lieberman J, Pollack S, Munne R, Safferman A, Kane J, Kronig M, Cooper T
Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.
Psychopharmacology (Berl). 1993;112(1 Suppl):S85-9. doi: 10.1007/BF02245011.
The effects of clozapine on the dopamine and serotonin systems may underlie its atypical pharmacologic and clinical profile. To examine this hypothesis, we measured dopamine and serotonin plasma and cerebrospinal (CSF) metabolites and the relationship of these values to treatment response in 19 neuroleptic refractory and intolerant schizophrenic patients. Only a small change in the CSF and plasma homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5HIAA) levels was found. However, the pretreatment CSF HVA/5HIAA ratio and, to a lesser extent, the CSF HVA level predicted treatment response. These results suggest that the modest relationship between HVA and 5-HIAA and treatment response supports the involvement of both neurotransmitters in the pathophysiology of schizophrenia.
氯氮平对多巴胺和5-羟色胺系统的作用可能是其非典型药理和临床特征的基础。为验证这一假说，我们测定了19例对神经阻滞剂难治或不耐受的精神分裂症患者的多巴胺和5-羟色胺血浆及脑脊液（CSF）代谢产物，以及这些值与治疗反应的关系。仅发现脑脊液和血浆中高香草酸（HVA）和5-羟吲哚乙酸（5HIAA）水平有微小变化。然而，治疗前脑脊液HVA/5HIAA比值以及程度稍轻的脑脊液HVA水平可预测治疗反应。这些结果表明，HVA和5-HIAA与治疗反应之间的适度关系支持了这两种神经递质均参与精神分裂症病理生理学过程的观点。
