OPIOID-PEPTIDES, ADRENOCORTICOTROPIC HORMONE, AND IDIOPATHIC (ORTHOSTATIC) EDEMA

The effect of dextroamphetamine sulfate (Dexedrine) on plasma opioid p eptides, hormones, and other metabolites was studied in eight female s ubjects with idiopathic (orthostatic) edema and five healthy females. All subjects were given 20 mg of dextroamphetamine sulfate, a drug wid ely used in the treatment of this disorder, and blood samples were col lected before and 30, 60, and 90 minutes after treatment. Patients wit h idiopathic (orthostatic) edema had significantly lower plasma sodium levels but higher blood urea nitrogen, aldosterone, and renin levels. D-amphetamine decreased aldosterone and renin levels in both groups. Plasma adrenocorticotropin levels were lower whereas met-enkephalin le vels were higher in idiopathic (orthostatic) edema subjects compared t o control subjects. D-amphetamine had no significant effect on plasma beta-endorphin, adrenocorticotrophic hormone, or enkephalins. Our data indicate that opioid peptides, especially enkephalins, and adrenocort icotrophic hormone may be involved in the pathogenesis of idiopathic ( orthostatic) edema syndrome, but they seem uninvolved in the aldostero ne- and renin-lowering action of amphetamine. It is possible that amph etamine is acting further down the chain, either directly on the adren al and kidney or the microvasculature, rather than at hypothalamus-pit uitary axis.