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Am J Psychiatry 1991; 148:484-488
Copyright © 1991 by American Psychiatric Association
Relation of CSF neurotensin concentrations to symptoms and drug response of psychotic patients
DL Garver, G Bissette, JK Yao and CB Nemeroff
Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama, Birmingham 35294.
OBJECTIVE: The authors investigated the putative endogenous antipsychotic
neurotensin in relation to both psychotic symptoms and patterns of response
during treatment with an antipsychotic drug. METHOD: Twenty recently
admitted patients with mood-incongruent psychoses underwent 1) interviews
with the Schedule for Affective Disorders and Schizophrenia for diagnostic
evaluation and symptom profiles, 2) drug-free baseline measurements of CSF
neurotensin and homovanillic acid, and 3) close monitoring of a therapeutic
trial of haloperidol to determine latency of antipsychotic response.
RESULTS: A relative deficiency in CSF neurotensin was found in a subgroup
of psychotic women whose clinical response to haloperidol was delayed for
11 to 35 days after initiation of the neuroleptic. These patients had
greater thought disorder, delusions-hallucinations, behavioral
disorganization, and impaired functioning than did psychotic patients with
higher CSF concentrations of neurotensin. Neurotensin concentrations
increased during treatment with haloperidol. CONCLUSIONS: The study
provides further evidence that there is diminished availability of
neurotensin in some psychotic patients, with increases in neurotensin early
in neuroleptic treatment. Exploration of neurotensin receptor agonists as a
potentially novel class of antipsychotic compounds is suggested.
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