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Low Activity Associated With Good Prognosis and Good Response to Neuroleptic Treatment

David E. Sternberg, MD; Daniel P. van Kammen, MD, PhD; Pauline Lerner, PhD; James C. Ballenger, MD; Stephen R. Marder, MD; Robert M. Post, MD; William E. Bunney, Jr, MD

Arch Gen Psychiatry. 1983;40(7):743-747.

Abstract
• Dopamine β-hydroxylase (DBH), the enzyme that converts dopamine to norepinephrine, was measured in the CSF of 30 schizophrenic patients and 27 normal controls. The CSF DBH activity in the patients was not significantly different from that in controls. Levels of CSF DBH activity in individual patients were highly constant over time and were not influenced by clinical state or neuroleptic treatment. Low levels of DBH in CSF did significantly relate to good social and sexual functioning, good prognosis, less symptoms between hospitalizations, and excellent clinical response to neuroleptic treatment. We speculate from these data that low brain DBH activity may produce a type of vulnerability to psychotic decompensation and thereby influence the clinical course, although it does not cause schizophrenia, in general. Low CSF DBH activity may delineate a "reactive" subgroup from the heterogenous population of patients with diagnoses of schizophrenia.

Author Affiliations
From the Section on Neuropsychopharmacology, Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Md. Dr Sternberg is now with Yale University, New Haven, Conn; Dr Ballenger is now with the University of Virginia, Charlottesville; Dr Marder is now with UCLA.

Footnotes
Accepted for publication July 8, 1982.

Reprint requests to Clinical Research Unit, Department of Psychiatry, Yale University, 34 Park St, New Haven, CT 06508 (Dr Sternberg).

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