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Cerebral Ventricular Enlargement and Dopamine Synthesis Inhibition in Chronic Schizophrenia

Henry A. Nasrallah, MD; Joel E. Kleinman, MD, PhD; Daniel R. Weinberger, MD; J. Christian Gillin, MD; Richard Jed Wyatt, MD
Arch Gen Psychiatry. 1980;37(12):1427. doi:10.1001/archpsyc.1980.01780250113018.
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To the Editor.—  The Archives has published a series of studies by Weinberger et al related to lateral cerebral ventricular enlargement and apparent atrophic brain changes on computerized tomographic (CT) scans in over 50% of patients with chronic schizophrenia.1-3 In their January 1980 Archives article,3 Weinberger et al report the finding of poor response to neuroleptic treatment in chronic schizophrenic patients with ventricular enlargement compared with a matched control group of chronic schizophrenic patients who have normal ventricular size. Insofar as neuroleptics are dopamine (DA) receptor blockers, the poor response to these drugs in schizophrenic patients with ventricular enlargement suggests that the DA hypothesis may not be applicable to this group of schizophrenic patients.In light of this finding, we have reexamined the results of two earlier studies that failed to show a neuroleptic-potentiating effect in chronic schizophrenia of α-methyl-p-tyrosine (metyrosine), a dopamine synthesis inhibitor.4.5


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