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Sam Castellani, MD; Michael G. Ziegler, MD; Daniel P. van Kammen, MD, PhD; Paul E. Alexander, MD; Samuel G. Siris, MD; Charles R. Lake, MD

Arch Gen Psychiatry. 1982;39(10):1145-1149.

Abstract
• Plasma norepinephrine (NE) and dopamine-β-hydroxylase (DBH) activity may be altered by changes in posture, pulse rate, and BP. Twenty-three drug-free schizophrenic, ten schizoaffective, and 24 normal control subjects, and a separate group of eight schizophrenic patients treated with chlorpromazine hydrochloride and haloperidol comprised the sample. Drug-free schizophrenic patients showed higher plasma NE levels while standing and higher pulse rates when supine and standing than normal subjects. Following chlorpromazine therapy, but not following haloperidol treatment, plasma NE level increased with patients supine and standing, pulse rate increased with patients standing, and systolic BP decreased with patients standing. These findings suggest (1) a decreased peripheral -adrenergic postsynaptic receptor sensitivity in schizophrenia and (2) a peripheral -adrenergic blocking mechanism in chlorpromazine-induced hypotension.

Author Affiliations
From the Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston (Dr Castellani); Department of Medicine, University of California, San Diego (Dr Ziegler); Section on Neuropsychopharmacology, Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Md (Dr van Kammen); Department of Psychiatry and Human Behavior, Brown University, Providence, RI (Dr Alexander); Department of Psychiatry, Mount Sinai School of Medicine, City University of New York (Dr Siris); and the Department of Psychiatry and Pharmacology, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Md (Dr Lake). Dr Castellani is now in private practice in Youngstown, Ohio.

Footnotes
Accepted for publication Feb 25, 1982.

Reprint requests to 2111 Belmont Ave, PO Box 2169, Youngstown, Ohio 44504 (Dr Castellani).

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