EARLY-ONSET ALCOHOLICS HAVE LOWER CEREBROSPINAL-FLUID 5-HYDROXYINDOLEACETIC ACID LEVELS THAN LATE-ONSET ALCOHOLICS

Background: We investigated the interrelationships of age at onset of excessive alcohol consumption, family history of alcoholism, psychiatr ic comorbidity, and cerebrospinal fluid monoamine metabolite concentra tions in abstinent, treatment-seeking alcoholics. Methods: We studied 131 recently abstinent alcoholics. Supervised abstinence was maintaine d on a research ward at the National Institutes of Health Clinical Cen ter for a minimum of 3 weeks. All alcoholics received a low-monoamine diet for a minimum of 3 days before lumbar puncture. Lumbar punctures were performed in the morning after an overnight fast. Monoamine metab olites and tryptophan in cerebrospinal fluid were quantified with liqu id chromatography by means of electrochemical detection. Psychiatric d iagnoses were established from blind-rated Schedule for Affective Diso rders and Schizophrenia-Lifetime version interviews administered by a research social worker. Severity and age at onset of excessive alcohol consumption were documented with a structured lifetime drinking histo ry questionnaire and with selected alcoholism screening questionnaires (CAGE and Michigan Alcoholism Screening Test). Family history of alco holism was obtained from the probands. Results: A majority of the trea tment-seeking, primarily white male alcoholics had a lifetime history of psychiatric disorders other than alcoholism None fulfilled criteria for antisocial personality disorder. Early-onset alcoholics (onset of excessive consumption before 25 years of age) had a more severe cours e of alcoholism and lower mean cerebrospinal fluid 5-hydroxyindoleacet ic acid concentration than late-onset alcoholics. Patients who reporte d both parents to be alcoholics had particularly low mean cerebrospina l fluid 5-hydroxyindoleacetic acid, homovanillic acid, and tryptophan concentrations. Conclusion: Among treatment-seeking alcoholics, early age at onset is generally associated with a more severe course of alco holism and lower cerebrospinal fluid 5-hydroxyindoleacetic acid concen tration.