PLASMA HOMOVANILLIC-ACID LEVELS AND THERAPEUTIC OUTCOME IN SCHIZOPHRENICS - COMPARISONS OF NEUROLEPTIC-NAIVE FIRST-EPISODE PATIENTS AND PATIENTS WITH DISEASE EXACERBATION DUE TO NEUROLEPTIC DISCONTINUANCE

Plasma homovanillic acid (pHVA) levels were measured and the Brief Psy chiatric Rating Scale (BPRS) scores were evaluated in 26 schizophrenic patients who had either never been medicated (neuroleptic-naive, firs t-episode subjects) or whose condition had become exacerbated followin g neuroleptic discontinuance (exacerbated subjects). All the subjects received medication with a fixed dose of a neuroleptic (haloperidol or fluphenazine, both 9 mg/day)for thr first week and variable doses for the subsequent 4 weeks, In the neuroleptic-naive subjects, pHVA level s increased significantly I week after starting the protocol, this inc rease correlated significantly with clinical improvement of the BPRS p ositive symptom scores at week 5. In the neuroleptic-naive subjects, p HVA levels had declined to the baseline level by, week 5. In the exace rbated subjects, there were no significant correlations between pHVA l evel changes at week 1 and later improvements of the BPRS positive sym ptom scores. These results suggest that the rise in pHVA levels occurr ing within I week after starting a fixed neuroleptic close may predict a favorable clinical response in neuroleptic-naive schizophrenic pati ents.