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Marked Reduction in Indexes of Dopamine Metabolism Among Patients With Depression Who Attempt Suicide

Marked Reduction in Indexes of Dopamine Metabolism Among Patients With Depression Who Attempt... Abstract • Cerebrospinal fluid studies have reported that low concentrations of the dopamine metabolite homovanillic acid are associated with suicidal behavior in depression. Although only a small proportion of homovanillic acid in the urine derives from the brain, we decided to examine 24-hour urinary outputs of homovanillic acid in relation to suicidal behavior in depression. Patients with depression who had attempted suicide had significantly smaller urinary outputs of homovanillic acid, dihydroxyphenylacetic acid, and total body output of dopamine (sum dopamine) than did patients with depression who had not attempted suicide. Patients with depression who reattempted suicide during 5-year follow-up had significantly smaller urinary outputs of homovanillic acid and sum dopamine than did patients who did not reattempt suicide, patients who never attempted suicide, and normal control subjects, and had significantly smaller outputs of dihydroxyphenylacetic acid than patients who never attempted suicide or control subjects. These data suggest that urinary outputs of homovanillic acid may be peripheral correlates of suicidalithomovanillicion. These data add to data on the low levels of homovanillic acid in cerebrospinal fluid in suggesting that diminished dopaminergic neurotransmission may play a part in suicidal behavior in depression. References 1. Asberg M, Nordstrom P, Traskman-Benz L. Biological factors in suicide . In: Roy A, ed. Suicide . Baltimore, Md: Williams & Wilkins; 1986:47-71. 2. Roy A, Linnoila M. Suicidal behavior, impulsiveness and serotonin . Acta Psychiatr Scand . 1988;78:529-535.Crossref 3. Roy A, Linnoila M. Monoamines and suicidal behavior. In: van Praag H, Plutchik R, Apter A, eds. Violence and Suicidality: Perspective in Clinical and Psychobiological Research . New York, NY: Brunner/ Mazel Inc; 1990:218-241. 4. Traskman L, Asberg M, Bertilsson L, Sjostrand L. Monoamine metabolites in CSF and suicidal behavior . Arch Gen Psychiatry . 1981;38:631636.Crossref 5. Roy A, Agren H, Pickar D, Linnoila M, Doran AR, Culter NR, Paul SM. Reduced CSF concentrations of homovanillic acid and homovanillic acid to 5-hydroxyindoleacetic acid ratios in depressed patients: relationship to suicidal behavior and dexamethasone nonsuppression . Am J Psychiatry . 1986;143:1539-1545. 6. Roy A, DeJong J, Linnoila M. Cerebrospinal fluid monoamine metabolites and suicidal behavior in depressed patients: a 5-year follow-up study . Arch Gen Psychiatry . 1989;46:609-612.Crossref 7. Roy A, Pickar D, Douillet P, Karoum F, Linnoila M. Urinary monoamines and metabolites in subtypes of unipolar depressive disorder and normal controls . Psychol Med . 1986;16:541-556.Crossref 8. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 9. Endicott J, Spitzer R. A diagnostic interview: the Schedule for Affective Disorder and Schizophrenia . Arch Gen Psychiatry . 1979;35:837-844.Crossref 10. Linnoila M, Karoum F, Miller T, Potter W. Reliability of urinary monoamine and metabolite output measurements in depressed patients . Am J Psychiatry . 1983;140:1055-1057. 11. Karoum F, Neff N. Quantitative gas chromatography-mass spectrometry (CG-MS) of biogenic amines: theory and practice . In: Spector S, Beck N, eds. Modern Methods in Pharmacology . New York, NY: Alan R Liss Inc; 1982;39-54. 12. van Praag H, Plutchik R. Increased suicidality in depression: group or subgroup characteristic? Psychiatry Res . 1988;26:273-278.Crossref 13. Maas J, Hattox S, Martin D, Landis D. A direct method for determining dopamine synthesis and output of dopamine metabolites from brain in awake animals . J Neurochem . 1979;32:839-843.Crossref 14. Kopin I, Bankiewicz K, Harvey-White J. Assessment of brain dopamine metabolism from plasma HVA and MHPG during debrisoquin treatment: validation in monkeys treated with MPTP . Neuropsychopharmacology . 1988;1:119-125.Crossref 15. Kopin I, Bankiewicz K, Harvey-White J. Effect of MPTP-induced parkinsonism in monkeys on the urinary excretion of HVA and MHPG during debrisoquin administration . Life Sci . 1988;43:133-141.Crossref 16. Lambert G, Eisenhofer G, Cox H, Horne N, Kalff V, Kelly M, Jennings J, Ester M. Direct determination of homovanillic acid release from the human brain: an indicator of central dopaminergic activity . Life Sci . 1991;49:1061-1072.Crossref 17. Karoum F, Korpi E, Chuang L, Linnoila M, Wyatt R. The effects of desiprimanine zimelidine, electroconvulsive treatment and lithium on rat brain biogenic amines: a comparison with peripheral changes . Eur J Pharmacol . 1986;121:377-385.Crossref 18. Karoum F, Fawcett R, Wyatt R. Chronic cocaine effects on peripheral biogenic amines: a long-term reduction in peripheral dopamine and phenylethylamine production . Eur J Pharmacol . 1988;148:381-388.Crossref 19. Davis K, Kahn R, Ko G, Davidson M. Dopamine in schizophrenia: a review and reconceptualization . Am J Psychiatry . 1991;148:14741486. 20. Davidson M, Giordani A, Mohs R, Mykytyn VV, Platt S, Aryan ZS, Davis KL. Control of exogenous factors affecting plasma homovanillic acid concentration . Psychiatry Res . 1987;20:307-312.Crossref 21. Roy A, Adinoff B, Roehrich L, Lamparski D, Custer R, Lorenz V, Barbaccia M, Guidotti A, Costa E, Linnoila M. Pathological gambling: a psychobiologic study . Arch Gen Psychiatry . 1988;45:369-373.Crossref 22. Banki C, Arato M. Amine metabolites and neuroendocrine responses related to depression and suicide . J Affect Disord . 1983;5:223-232.Crossref 23. Palaniappan V, Ramachandran V, Somasundaram O. Suicidal ideation and biogenic amines in depression . Indian J Psychiatry . 1983;25:286-292. 24. Montgomery S, Montgomery D. Pharmacological prevention of suicidal behaviour . J Affect Disord . 1982;4:291-298.Crossref 25. Agren H. Life at risk: markers of suicidality in depression . Psychiatry Dev . 1983;1:87-104. 26. Agren H, Mefford I, Rudorfer M, Linnoila M, Potter W. Interacting neurotransmitter system: a non-experimental approach to the 5-HIAA HVA correlation in human CSF . J Psychiatry Res . 1986;20:175-193.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Marked Reduction in Indexes of Dopamine Metabolism Among Patients With Depression Who Attempt Suicide

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Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1992.01820060027004
Publisher site
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Abstract

Abstract • Cerebrospinal fluid studies have reported that low concentrations of the dopamine metabolite homovanillic acid are associated with suicidal behavior in depression. Although only a small proportion of homovanillic acid in the urine derives from the brain, we decided to examine 24-hour urinary outputs of homovanillic acid in relation to suicidal behavior in depression. Patients with depression who had attempted suicide had significantly smaller urinary outputs of homovanillic acid, dihydroxyphenylacetic acid, and total body output of dopamine (sum dopamine) than did patients with depression who had not attempted suicide. Patients with depression who reattempted suicide during 5-year follow-up had significantly smaller urinary outputs of homovanillic acid and sum dopamine than did patients who did not reattempt suicide, patients who never attempted suicide, and normal control subjects, and had significantly smaller outputs of dihydroxyphenylacetic acid than patients who never attempted suicide or control subjects. These data suggest that urinary outputs of homovanillic acid may be peripheral correlates of suicidalithomovanillicion. These data add to data on the low levels of homovanillic acid in cerebrospinal fluid in suggesting that diminished dopaminergic neurotransmission may play a part in suicidal behavior in depression. References 1. Asberg M, Nordstrom P, Traskman-Benz L. Biological factors in suicide . In: Roy A, ed. Suicide . Baltimore, Md: Williams & Wilkins; 1986:47-71. 2. Roy A, Linnoila M. Suicidal behavior, impulsiveness and serotonin . Acta Psychiatr Scand . 1988;78:529-535.Crossref 3. Roy A, Linnoila M. Monoamines and suicidal behavior. In: van Praag H, Plutchik R, Apter A, eds. Violence and Suicidality: Perspective in Clinical and Psychobiological Research . New York, NY: Brunner/ Mazel Inc; 1990:218-241. 4. Traskman L, Asberg M, Bertilsson L, Sjostrand L. Monoamine metabolites in CSF and suicidal behavior . Arch Gen Psychiatry . 1981;38:631636.Crossref 5. Roy A, Agren H, Pickar D, Linnoila M, Doran AR, Culter NR, Paul SM. Reduced CSF concentrations of homovanillic acid and homovanillic acid to 5-hydroxyindoleacetic acid ratios in depressed patients: relationship to suicidal behavior and dexamethasone nonsuppression . Am J Psychiatry . 1986;143:1539-1545. 6. Roy A, DeJong J, Linnoila M. Cerebrospinal fluid monoamine metabolites and suicidal behavior in depressed patients: a 5-year follow-up study . Arch Gen Psychiatry . 1989;46:609-612.Crossref 7. Roy A, Pickar D, Douillet P, Karoum F, Linnoila M. Urinary monoamines and metabolites in subtypes of unipolar depressive disorder and normal controls . Psychol Med . 1986;16:541-556.Crossref 8. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 9. Endicott J, Spitzer R. A diagnostic interview: the Schedule for Affective Disorder and Schizophrenia . Arch Gen Psychiatry . 1979;35:837-844.Crossref 10. Linnoila M, Karoum F, Miller T, Potter W. Reliability of urinary monoamine and metabolite output measurements in depressed patients . Am J Psychiatry . 1983;140:1055-1057. 11. Karoum F, Neff N. Quantitative gas chromatography-mass spectrometry (CG-MS) of biogenic amines: theory and practice . In: Spector S, Beck N, eds. Modern Methods in Pharmacology . New York, NY: Alan R Liss Inc; 1982;39-54. 12. van Praag H, Plutchik R. Increased suicidality in depression: group or subgroup characteristic? Psychiatry Res . 1988;26:273-278.Crossref 13. Maas J, Hattox S, Martin D, Landis D. A direct method for determining dopamine synthesis and output of dopamine metabolites from brain in awake animals . J Neurochem . 1979;32:839-843.Crossref 14. Kopin I, Bankiewicz K, Harvey-White J. Assessment of brain dopamine metabolism from plasma HVA and MHPG during debrisoquin treatment: validation in monkeys treated with MPTP . Neuropsychopharmacology . 1988;1:119-125.Crossref 15. Kopin I, Bankiewicz K, Harvey-White J. Effect of MPTP-induced parkinsonism in monkeys on the urinary excretion of HVA and MHPG during debrisoquin administration . Life Sci . 1988;43:133-141.Crossref 16. Lambert G, Eisenhofer G, Cox H, Horne N, Kalff V, Kelly M, Jennings J, Ester M. Direct determination of homovanillic acid release from the human brain: an indicator of central dopaminergic activity . Life Sci . 1991;49:1061-1072.Crossref 17. Karoum F, Korpi E, Chuang L, Linnoila M, Wyatt R. The effects of desiprimanine zimelidine, electroconvulsive treatment and lithium on rat brain biogenic amines: a comparison with peripheral changes . Eur J Pharmacol . 1986;121:377-385.Crossref 18. Karoum F, Fawcett R, Wyatt R. Chronic cocaine effects on peripheral biogenic amines: a long-term reduction in peripheral dopamine and phenylethylamine production . Eur J Pharmacol . 1988;148:381-388.Crossref 19. Davis K, Kahn R, Ko G, Davidson M. Dopamine in schizophrenia: a review and reconceptualization . Am J Psychiatry . 1991;148:14741486. 20. Davidson M, Giordani A, Mohs R, Mykytyn VV, Platt S, Aryan ZS, Davis KL. Control of exogenous factors affecting plasma homovanillic acid concentration . Psychiatry Res . 1987;20:307-312.Crossref 21. Roy A, Adinoff B, Roehrich L, Lamparski D, Custer R, Lorenz V, Barbaccia M, Guidotti A, Costa E, Linnoila M. Pathological gambling: a psychobiologic study . Arch Gen Psychiatry . 1988;45:369-373.Crossref 22. Banki C, Arato M. Amine metabolites and neuroendocrine responses related to depression and suicide . J Affect Disord . 1983;5:223-232.Crossref 23. Palaniappan V, Ramachandran V, Somasundaram O. Suicidal ideation and biogenic amines in depression . Indian J Psychiatry . 1983;25:286-292. 24. Montgomery S, Montgomery D. Pharmacological prevention of suicidal behaviour . J Affect Disord . 1982;4:291-298.Crossref 25. Agren H. Life at risk: markers of suicidality in depression . Psychiatry Dev . 1983;1:87-104. 26. Agren H, Mefford I, Rudorfer M, Linnoila M, Potter W. Interacting neurotransmitter system: a non-experimental approach to the 5-HIAA HVA correlation in human CSF . J Psychiatry Res . 1986;20:175-193.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jun 1, 1992

References