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Catecholamine Metabolism in Affective Disorders II. Norepinephrine, Normetanephrine, Epinephrine, Metanephrine, and VMA Excretion in Hypomanic Patients

Kenneth Greenspan, MD; Joseph J. Schildkraut, MD; Edna K. Gordon; Bernard Levy, MD; Jack Durell, MD
Arch Gen Psychiatry. 1969;21(6):710-716. doi:10.1001/archpsyc.1969.01740240070009.
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THE FAIRLY consistent correlation between the clinical effects of drugs used in the treatment of manic-depressive disorders and the alterations in the metabolism of biogenic amines (particularly norepinephrine and serotonin) produced by these drugs has stimulated the investigation of catecholamine and indoleamine metabolism in patients with affective disorders.1-4 Direct assay of monoamine metabolism in the central nervous system in man is, of course, not feasible and most studies have examined the urinary excretion of the various biogenic amines or one or another of their metabolites.

The investigation of catecholamine metabolism in affective disorders has been of particular interest to us. The literature on studies in depressed patients has recently been reviewed.5 Changes in catecholamine metabolism in hypomanic patients have been studied less extensively. Urinary excretion of norepinephrine and epinephrine has been found to be greater during periods of mania


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