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Am J Psychiatry 1982; 139:991-997
Copyright © 1982 by American Psychiatric Association
d-Amphetamine-induced heterogeneous changes in psychotic behavior in schizophrenia
DP van Kammen, WE Bunney Jr, JP Docherty, SR Marder, MH Ebert, JE Rosenblatt and JN Rayner
In this placebo-paired, double-blind study, 13 of 45 schizophrenic patients
showed an acute improvement in schizophrenic symptoms following
d-amphetamine infusion (20 mg). The 18 patients who worsened tended to have
higher CSF 3-methoxy-4-hydroxyphenylglycol levels than did those who
improved. d-Amphetamine blood levels and clinical descriptors of
schizophrenic subgroups did not differentiate patients who improved from
those who worsened; however, patients who improved had been significantly
more psychotic before the infusion. Patients who worsened had been more
psychotic than those who did not change. The authors suggest that those who
did not change. The authors suggest that sensitivity to dopamine
stimulation in schizophrenia is state-dependent rather than trait-dependent
and that the simple, undirectional hypothesis of schizophrenia needs to be
reformulated.
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