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II. Plasma and Urinary Monoamine Findings After Treatment

Alan Zametkin, MD; Judith L. Rapoport, MD; Dennis L. Murphy, MD; Markku Linnoila, MD, PhD; Farouk Karoum, PhD; William Z. Potter, MD; Deborah Ismond, MA

Arch Gen Psychiatry. 1985;42(10):969-973.

Abstract
• Urinary monoamines and metabolites as well as plasma norepinephrine (NE) and 3-methoxy-4-hydroxyphenylglycol were measured in 14 boys (mean age, 9.2 years) with Attention Deficit Disorder With Hyperactivity during an initial placebo period, after four weeks of treatment with either dextroamphetamine sulfate (N = 5) or a monoamine oxidase inhibitor (N =9) and at the end of a subsequent two-week placebo "washout" period. Both dextroamphetamine and monoamine oxidase inhibitors produced persistent changes in monoamines and metabolites, which were most marked and consistent for NE and its metabolite 3-methoxy-4-hydroxyphenylglycol. These changes did not correlate in a consistent fashion with clinical response during drug treatment. Moreover, there was rapid clinical relapse following cessation of either treatment while the alterations in NE metabolism remained during the two weeks following drug, further demonstrating the independence of these changes from clinical state. Future studies with dextroamphetamine need drug-free periods that are greater than 14 days to obtain true "baseline" conditions.

Author Affiliations
From the Child Psychiatry Branch (Drs Zametkin and Rapoport and Ms Ismond), Neuropharmacology Branch (Dr Murphy), Adult Psychiatry Branch, St Elizabeths Hospital (Dr Karoum), and Laboratory of Clinical Science (Dr Potter), National Institute of Mental Health, and the Laboratory of Clinical Studies, National Institute of Alcohol Abuse and Alcoholism (Dr Linnoila), Bethesda, Md. Dr Zametkin was a child psychiatry fellow at George Washington University, Washington, DC.

Footnotes
Accepted for publication Aug 13, 1984.

Reprint requests to Child Psychiatry Branch, National Institute of Mental Health, Bldg 10, Room 6N240, 9000 Rockville Pike, Bethesda, MD 20205 (Dr Rapoport).

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