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Impaired Presynaptic Regulation of Norepinephrine in Schizophrenia Effects of Clonidine in Schizophrenic Patients and Normal Controls

David E. Sternberg, MD; Dennis S. Charney, MD; George R. Heninger, MD; James F. Leckman, MD; Karen M. Hafstad, BSN; D. Harold Landis
Arch Gen Psychiatry. 1982;39(3):285-289. doi:10.1001/archpsyc.1982.04290030025004.
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• Recent studies have found elevated levels of norepinephrine (NE) in CSF and brain specimens from schizophrenic patients. Presynaptic inhibitory α2-adrenergic receptors regulate NE release in the brain. The hypothesis that the functional sensitivity of this presynaptic regulation of NE is impaired in schizophrenia was tested by evaluating, in schizophrenic patients and age-matched normal controls, the ability of clonidine, an alpha2 agonist, to lower plasma levels of the NEmetabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) and to lower blood pressure (BP). Clonidine produced a significant decrease in plasma MHPG levels in the normal control group, but did not lower plasma MHPG levels in the schizophrenic patients. Clonidine decreased BP equally in both groups. These results suggest that there is a functional subsensitivity of the inhibitory presynaptic α2-adrenergic receptor in schizophrenia, which may relate to an impaired regulation of NE turnover.


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