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Probenecid-Induced Norepinephrine Elevations in Plasma and CSF

C. Raymond Lake, MD, PhD; James H. Wood, MD; Michael G. Ziegler, MD; Michael H. Ebert, MD; Irwin J. Kopin, MD
Arch Gen Psychiatry. 1978;35(2):237-240. doi:10.1001/archpsyc.1978.01770260115014.
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• Probenecid administered in divided oral doses totaling 100 mg/kg increased levels of norepinephrine (NE) in plasma and cerebrospinal fluid (CSF). This technique is commonly used to measure the rate of accumulation of acidic metabolites of certain brain neurotransmitter biogenic amines in CSF after blockade of their transport into blood. Since levels of 3-methoxy-4-hydroxyphenylethyleneglycol, a neutral metabolite of NE, are also elevated after high oral doses of probenecid, the increases of CSF and plasma NE levels may be directly related to probenecidinduced release of this amine from noradrenergic neurons.

In patients who experienced nausea or vomiting there were lower levels of probenecid in CSF, probably secondary to diminished absorption of the medication. These patients also had lower levels of NE in plasma than did patients who remained asymptomatic.

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