Schulz E, Remschmidt H, Fleischhaker C
Klinik für Kinder- und Jugendpsychiatrie, Philipps-Universität Marburg.
Z Kinder Jugendpsychiatr. 1994 Dec;22(4):285-98.
Longitudinal assessments (every six weeks for one year) were made of plasma norepinephrine, dopamine, epinephrine and 3-methoxy-4-hydroxyphenylglycol (MHPG) in 40 adolescents with schizophrenia, 20 on clozapine therapy and 20 on conventional medication. In addition to the plasma catecholamine determinations, serum levels of 5-HT were determined as a measure of serotoninergic status. All analyses were performed by HPLC-ECD (high-performance liquid chromatography with electrochemical detection). Clinical ratings of symptomatology were obtained with the Brief Psychiatric Rating Scale (BPRS) and the Andreasen scales for negative and positive symptoms (SANS and SAPS). Compared with the typical neuroleptic medication, clozapine administration was accompanied by a significant increase in plasma norepinephrine and MPHG and serum serotonin levels. The fluctuations in the biogenic amines were closely associated with the observed symptomatology. Plasma MHPG was linked to depressive symptoms (BPRS), and negative symptoms (SANS) were related to changes in the serum serotonin levels. The pathophysiological implications and clinical consequences of these findings are discussed.
对40名精神分裂症青少年进行了纵向评估（为期一年，每六周一次），其中20名接受氯氮平治疗，20名接受传统药物治疗，评估指标包括血浆去甲肾上腺素、多巴胺、肾上腺素和3-甲氧基-4-羟基苯乙二醇（MHPG）。除了测定血浆儿茶酚胺外，还测定了血清5-羟色胺水平，以衡量血清素能状态。所有分析均采用高效液相色谱-电化学检测法（HPLC-ECD）进行。采用简明精神病评定量表（BPRS）以及安德烈亚森阴性和阳性症状量表（SANS和SAPS）对症状进行临床评定。与典型的抗精神病药物相比，服用氯氮平会使血浆去甲肾上腺素、MHPG和血清血清素水平显著升高。生物胺的波动与观察到的症状密切相关。血浆MHPG与抑郁症状（BPRS）有关，阴性症状（SANS）与血清血清素水平的变化有关。本文讨论了这些发现的病理生理学意义和临床后果。
