EXCRETION OF BETA-CARBOLINES HARMAN AND NORHARMAN IN 24-HOUR URINE OFCHRONIC-ALCOHOLICS DURING WITHDRAWAL AND CONTROLLED ABSTINENCE

Animal experiments suggest that endogenous substances that could resul t from the interaction between neurotransmitters (dopamine and indolea mines) and ethanol and its metabolite acetaldehyde might be involved i n the pathogenesis and maintenance of alcohol dependence. Therefore, a romatic beta-carbolines (norharman and harman) were investigated repea tedly in 24-hr urine of 13 male severe alcoholics without any psychiat ric comorbidity during a controlled inpatient abstention program of up to 8 weeks. Harman excretion was similar to 2-fold above levels in co ntrol subjects, with a steady decline after 3 weeks of abstinence and lower levels in patients with a longer duration of alcohol dependence, Severity of withdrawal symptoms and actual feelings of anxiety/depres sion were negatively associated with urinary harman excretion. positiv e associations could be established with daily ethanol consumption the month before admission and the score on the scale ''reward dependence '' according to Cloninger's Tridimensional personality Questionnaire. Moreover, patients without alcohol-dependent first-degree relatives an d higher ''reward dependence'' exhibited an increased excretion of har man. Therefore, barman levels might characterize a distinct subgroup o f alcoholic patients, who in part resemble the so-called type I alcoho lics of Cloninger. However, this awaits further study in a larger numb er of individuals. In contrast, norharman excretion was elevated up to 6-fold, compared with nonalcoholics over 6 to 8 weeks of controlled a bstention. No correlations to demographic or clinical variables could be observed. Therefore, increased norharman levels might be proposed a s a ''residual marker'' or a trait variable. Whether the observed chan ges are specific markers of at least certain aspects of alcoholism or dependence remain to be elucidated.