HOMOVANILLIC-ACID IN THE CEREBROSPINAL-FLUID - PATTERNS OF RESPONSE AFTER 4 WEEKS OF NEUROLEPTIC TREATMENT

Lumbar cerebrospinal fluid (CSF) homovanillic acid (HVA) concentration s were measured before and after 4 weeks of neuroleptic treatment in s chizophrenic (n = 15) and schizoaffective (n = 4) patients. Neurolepti c treatment induced a nonsignificant (17%) increase in CSF HVA group m ean levels. For the total group, no correlations were found between pr etreatment CSF HVA and clinical measures, or between changes in HVA an d clinical response. An alternative interpretation was attempted by de fining ''tolerant'' and ''nontolerant'' subgroups. A ''tolerant'' resp onse was defined as a reduction in posttreatment HVA values below pret reatment levels, whereas a ''nontolerant'' response was characterized by posttreatment values above pretreatment levels. When thus defined, nontolerant patients had a significantly inferior clinical response to neuroleptics, in contrast to their tolerant counterparts. Further, al though there was no difference in pretreatment CSF HVA values between these two groups, pretreatment clinical profiles did differ significan tly. Also, in a retrospective analysis, nontolerant patients were foun d to have a significantly earlier age of illness onset, a greater numb er of prior psychiatric hospitalizations, and more time spent in psych iatric hospitals.