Plasma homovanillic acid in psychotic depression

Abstract

AbstractElevated levels of plasma homovanillic acid (HVA) are associated with increased psychopathology after neuroleptic withdrawal in schizophrenia, and may be predictive of treatment response in psychotic patients. There are limited extant data on plasma HVA in psychotic and non‐psychotic major depression. In 53 medication‐free inpatients with endogenous depression, single determinations of AM plasma HVA did not differ between psychotic (n = 20) and non‐psychotic (n = 33) patients. Plasma HVA showed no associations with age, gender, or indices of disease severity. Consistent with prior reports, a course of ECT treatment did not significantly change plasma HVA levels in this depressed sample, and there were no effects of ECT modality or clinical response on plasma HVA levels.These results, though limited by the absence of serial sampling, suggest that plasma HVA abnormalities may not characterize psychotic depression, unlike the findings in schizophrenia. The existence of multiple subtypes of dopamine receptors, and the possibility of different abnormalities in the mesolimbic and prefrontal dopaminergic pathways in schizophrenia, complicates the interpretation of peripheral dopaminergic markers. The significance of peripheral markers such as plasma HVA remains uncertain, though at this stage the clinical correlates in schizophrenia are better established than those in psychotic depression. Further work is necessary to clarify the utility of peripheral markers of the dopamine system in psychotic disorders. Depression 1:309–314 (1993). © 1993 Wiley‐Liss, Inc.