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Arthur J. Prange, Jr, MD; Peter T. Loosen, MD; Ian C. Wilson, MD; Herbert Y. Meltzer, MD; Victor S. Fang, PhD

Arch Gen Psychiatry. 1979;36(10):1086-1093.

Abstract
• We studied the effects of intravenous protirelin (thyrotropin-releasing hormone) in 17 schizophrenic patients and 17 normal subjects. A total of 12 patients received protirelin, 0.5 mg, and, on another occasion, niacin, 2 mg, in a double-blind, crossover design. Both behavioral and endocrine data were collected. Five patients received protirelin in an open trial; only endocrine data were collected. Protirelin caused about a 50% prompt decrease in psychotic symtpoms. Patients then tended slowly to experience a relapse. Side effects were about as infrequent after protirelin as after niacin. We assayed serum prolactin (PRL), growth hormone (GH), thyroid-stimulating hormone (TSH), L-triiodothyronine (T₃) and thyroxine (T₄). Free T₄ (FT₄) index was calculated. The values for PRL, GH, and TSH at baseline and after protirelin stimulation were normal. Patients showed lower T₃ values at baseline, but a brisker T₃ response to protirelin, than controls. Their FT₄ indices were higher at baseline. Patients showed diminished T₄ binding sites rather than increased total T₄. The causes of these alterations in thyroid dynamics are unidentified.

Author Affiliations
From the Department of Psychiatry (Drs Prange and Loosen), Biological Sciences Research Center, University of North Carolina, Chapel Hill; the Division of Research (Dr Wilson), North Carolina Department of Mental Health, Raleigh; and the Departments of Psychiatry (Dr Meltzer) and Medicine (Dr Fang), the University of Chicago.

Footnotes
Accepted for publication March 23, 1979.

Reprint requests to Division of Health Affairs, University of North Carolina, School of Medicine, Chapel Hill, NC 27514 (Dr Prange).

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