• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.84-94
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• 1997

This study was done to examine changes of plasma homovanillic acid(HVA), 5-hydroxyindoleacetic acid(5-HIAA), and HVA/5-HIAA ratio during an 8-week clozapine trial and to investigate the relationship between the plasma monoamine metabolites and treatment responses. Twenty-seven chronic schizophrenic patiens were treated for 8 weeks with clozapine. The psychopathology was assessed at baseline just clozapine trial and then every 2 weeks until the end of 8-week clozapine treatment using the Positive and Negative Syndrome Scale(PANSS) and the Clinical Global Impression scale(CGI). The plasma HVA and 5-HIAA levels were measured also biweekly using high preformance liquid chromatography with electrochemical detection method. Plasma HVA and 5-HIAA levels were significantly decreased during a 8-week clozapine treatment, although plasma HVA/5-HIAA ratio showed no significant change. The changes of plasma HVA levels were in significant correlations with the changes of PANSS positive scores, of general psychophathology scores, and changes of total socres. The changes of plasma 5-HIAA levels were in signfificant correlations with the changes of PANSS negative scores. But the changes of plasma HVA/5-HIAA ratio had no significant correlation with any PANSS subscale score changes. 48% of the patients treated with clozapine was categorized as responders, who showed at least a 20% decrease in PANSS total socre and a CGI severity score of mildly ill or less(${\leq}3$) at the end pint of the study. The baseline plasma HVA levels and HVA/5-HIAA ratio were significantly higher in responders(N=13) than in nonresponders (N=14). But no significant difference in baseline levels of plasma 5-HIAA was found between responders and nonresponders. At the end point of the study, there was significant difference in the change of plasma HVA between responders(40.3% decrement) and nonresponders(3.1% increment). But no signficant differences in the change of plasma 5-HIAA and the change of plasma HVA/5-HIAA ratio between responders and nonresponders were observed. These results suggest that the antipsychotic effect of clozapine on positive symptoms may be associated with dopaminergic blocking activity, and that on negative symptoms may be associated with serotonergic blocking activity. The baseline plasma HVA levels and the change of HVA levels from baseline may be useful predictors of treatment response with clozapine.

• Analytical Science and Technology
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• v.20 no.3
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• pp.204-212
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• 2007

The study was carried out to investigate the ratio of ethanol to n-propanol in blood and urine specimens, and developed a method for distinguishing ingested ethanol from artifactual ethanol in urine samples. In case of no urinary ethanol was detected, the ratio of ethanol to n-propanol concentration was about 12~20 times higher than those of blood. Therefore, it might be a good method to determine whether the detected ethanol is from drinking or from microbial fermentation. During the metabolism of ethanol, the levels of the metabolite of serotonin (5-hydroxytryptamine, 5-HT) and 5-hydroxyindole-3-acetic acid (5-HIAA) were decreased, while 5-hydroxytryptophol (5-HTOL) was increased. The levels of 5-HTOL/5-HIAA in urine samples of drinking suspects were greater than 1, in that of no drinking suspects were less than 1.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.2
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• pp.165-178
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• 2001

In order to elucidate the biological etiology and the relationship between the ontogenesis of serotonin system and psychopathology in ADHD, plasma serotonin(5-hydroxytryptamine, 5-HT) and 5-hydroxyindoleacetic acid(5-HIAA) were measured and the correlation between the plasma levels of 5-HT and 5-HIAA and age were evaluated in 46 ADHD patients and 18 control subjects. The ADHD patients were composed of 16 combined type, 10 inattentive type, and 20 hyperactive-impulsive type and the control subjects were communication disorders. The results are summarized as follows：1) There was significant difference in plasma 5-HT levels among combined, inattentive and hyperactive-impulsive and control subjects(ANOVA F=4.33, df 3, 60, p<0.05), and post-hoc test using Scheffe method showed significant difference between the combined type and control group. But, post-hoc tests showed no significant differences between combined and inattentive, combined and hyperactive-impulsive, hyperactive-impulsive and inattentive, hyperactive-impulsive and control and inattentive and control groups. 2) There was no significant differences in plasma 5-HIAA levels among the combined, hyperactive- impulsive, inattentive and control groups(ANOVA F=2.08, df 3, 60, p>0.05). 3) Significant difference in 5-HT level was found between the whole ADHD group(N=46) and the control group(N=18)(T=3.10, df 62, p<0.05). But no significant difference in 5-HIAA level was found between the whole ADHD group and the control group(T=1.90, df 62, p>0.05). 4) Plasma 5-HT and 5-HIAA levels showed no significant correlation with TOVA findings(5-HT：omission pearson correlation 0.10, commision 0.23, reaction time 0.01, variability in attention 0.11, all p>0.05, 5-HIAA：omission 0.21, commision 0.15, reaction time 0.09, variability in attention 0.15, all p>0.05). 5) Plasma 5-HT and 5-HIAA levels showed no significant correlation with attention, hyperactivity and impulsivity based on DSM-IV criteria. 6) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age both in ADHD and control group. These findings show that decreased plasma 5-HT level may play a role in the genesis of ADHD, but this finding has no significant correlation with the psychopathology of ADHD. And we could not find any significant differences in ontogenetic processes in 5-HT. Future studies should be focused on the drug effects, family history and prognosis based on the biochemical subtypes(high and low 5-HT group).

• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.95-101
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• 1997

The recent hypothesis about the pathophysiology of schizophrenia has been centered mainly on two theories, i.e. dopamine hypothesis and serotonin hypothesis. We investigate the correlations between plasma monoamine metabolite concentrations and clinical symptoms in schizophrenic patients. The first purpose of our study was to examine whether the plasma levels of HVA(homovanillic acid) and 5-HIAA(hydroxyindoleacetic acid) are significantly different in schizophrenics, compared to normal controls. And, with the intention of clarifying the interaction between dopaminergic system and serotoninergic system, the ratio of HVA/5-HIAA also was measured. The second purpose was whether the basal(pre-treatment) levels of these metabolites show the correlation with clinical symptoms. Finally, third purpose was whether basal HVA and 5-HIAA levels can be held as a predictor of treatment response. We used Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS) as the clinical symptom rating scales. Our results were as followed, 1) only the level of basal plasma HVA was significantly differ in schizophrenics. 5-HIAA and HVA/5-HIAA were not. 2) basal HVA showed significant correlation with SAPS score, especially delusion subscale. 3) the higher was the basal HVA level, the more improvement in clinical symptoms was observed. The basal 5-HIAA level and the HVA/5-HIAA ratio did not show any significant findings. These results support the dopamine hypothesis of schizophrenia, but fail to examine on the possible involvement of serotonin in schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.269-276
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• 1996

Object : The aim of this study was to examine an association between plasma 5-Hydroxyindoleacetic Acid(HIAA) level and the change of depressive symptom after fluoxetine trial in haloperidol-stabilized schizoprenic in-patients. Method : According to plasma 5-HIM level, 32 patients were classified to either group with high 5-HIAA level(N=11) or that with low 5-HIM(N=11). For each patient, fluoxetine(20mg/day) added to stable haloperidol dose for 6 weeks. The authors measured Hamilton Rating Scale for Depression (HRSD) at baseline, the 2nd week, the 4th week, the 6th week of treatment. Result : 1) Age, duration of illness, number of admission, duration of present admission, dosage of haloperidol between high 5-HIAA group and low 5-HIM group were significantly different. 2) As time went on, the association between the change of depressive symptom and plasma 5-HIAA concentration was not significant. 3) Of depressed group, as lime went an, depressive symptoms were improved significantly in high 5-HIAA group, but not in law 5-HIM group. Conclusion : We suggest that the association between plasma 5-HIAA level and the change of depressive symptoms after fluoxetine trial in haloperidol stabilized schizophrenic in-patients was not significant.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.77-90
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• 1995

The Purposes of this study were to examine plasma homovanillic acid(pHVA) levels and 5-hydroxyindoleacetic acid(pHIAA) levels in schizophrenics during haloperidol treatment, and to assess the association of pHVA and pHIM levels with their psychopathology and treatment responses. Fourteen patients entered the study and pHVA, pHIAA levels were measured at baseline, first week, second week and fourth week during treatment. Also, plasma haloperidol levels were measured at first week, second week and fourth week. Psychopathology was evaluated with Brief Psychiatric Rating Scale(BPRS) at baseline, 1st week, 2nd week and 4th week. 1) There were significant differences on the duration of illness and total BPRS scores at baseline between higher pHVA group(baseline pHVA level >7.72ng/mL) and lower pHVA group(baseline pHVA level <7.72ng/mL). 2) There was no significant difference on the duration of illness between higher pHIM group(baseline pHIAA level >3.18ng/mL). and lower pHIAA group(baseline pHIAA level <3.18ng/mL). 3) The Means of pHVA levels at 1 st week and 2nd week after treatment decreased significantly in the higher pHVA group and did not change in the lower pHVA group. 4) In the higher pHIAA group, the mean of pHIAA levels at 4th week after treatment decreased significantly, but did not change in the lower pHIAA group. 5) Between the higher pHIVA group and lower pHVA group, the response rates(percentile improvement) after treatment were not different from each other, but there was significant difference on the response rate between the lower pHIAA group and higher pHIM group at 2nd week. 6) There was significant correlation between total BPRS scores and pHVA levels in the higher pHVA group during treatment. The results suggest that repeated measurement of pHVA levels and pHIAA levels following antipsychotic treatment have prognostic significance for response. Also, shcizophrenics whose have relatively nigh levels of pHVA, or relatively low levels of pHIAA before treatment will show a favorable early responses to antipsychotics.

• Journal of Oriental Neuropsychiatry
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• v.3 no.1
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• pp.25-45
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• 1992

Many phychiatrists have reported that the change of serotonin concentration would cause mental disorder and affect the pathological conditions such as schizophrenia, depression and eating behabior. The end product of serotonin metabolism was excreted as 5-HIAA in urine. Serum lipids, according to the report, were concerned with obesity, said it was. This study aims to observe the changes of plasma serotonin, urinary 5-HIAA and serum lipids, making use of Fat Cell Mass rate of 27 normal persons and 42 psychosomatic patients. For this, I also observed the change of serotonin, 5-HIAA and lipids of the psychosomatic patients by the use of 3 kinds of herbs as treatment medication on the basis of physical symptoms and the results were obtained as follows; 1. Urinary 5-HIAA is correlated with the body water rate(r=0.381), while reversely correlated with the Fat Cell Mass rate(r=-0.330). 2. Compared the control group with the patients group for the serum lipids value, they showed the significant results ; $146.4{\pm}5.71$ mg/dl and $166.9{\pm}6.56$ mg/dl in the total cholestrol value over- weights, $471.2{\pm}42.99$ mg/dl in the total lipid value, and $158.1{\pm}6.50$ mg/dl and $181.1{\pm}6.30$ mg/dl in the phospholipid of the obesity, respectively. 3. With comparison of each group to other group to the others for Fat Cell Mass rate, the total cholesterol showed the significant differences when the Fat Cell Mass rate was 20% or more, HDL-cholesterol value when 30% or more, and triglyceride when 30% or more, respectively. 4. there was significant variations in the relations between Fat Cell Mass rate and body water, which body mass index was increased as the body water was decreased. 5. Fat Cell Mass rate was correlated with Cholesterol(r = 0.420), triglyceride (r = 0.443), and $\beta$-lipoprotein(r = 0.450) of serum lipids, while reversely correlated with HDL -Cholesterol(r = -0.354) and urinary 5- HIAA had the correlation coefficient of -0.330. 6. What related with body water rate urinary 5-HIAA (r = 0.381) and $\beta$-lipoprotein(r = -0.405). 7. there were significant changes in the total cholesterol value and HDL-Cholesterol Value of serum lipids after dose of Ondamtang, significant increase in the 5-HIAA value after dose of Samulansintang, and significant devrease in the Trigylceride value of serum lipids after dose of Shihosogansan. As a result, it was seen that there was direct correlations among the Fat Cell Mass, urinary 5-HIAA, and serum lipids and stress from the mental conditions was not correlated directly to Serotonin, 5-HIAA, and serum lipids. I would like to conclude, therefore, that the detailed study should be performed on the function of serotonin of hypothalamus.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.811-816
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• 1999

Background : Nausea and vomiting associated with chemotherapy are common side effects which remain difficult to control. Acute phase nausea and vomiting (0-24 hours after induction of chemotherapy) parallels plasma serotonin release, which explains the effectiveness of $5-HT_3$ receptor antagonists. Serotonin released from gastrointestinal enterochromaffin cells may mediate chemotherapy-induced emesis. In this study, we analyzed urinary excretion of 5-HIAA, the main metabolite of serotonin. Methods : Eight men and four women were studied in their cisplatin chemotherapy cycle. Urinary 5-hydroxyindoleaoetic aicd (HIAA) levels were determined before and during a 24-hour period under ondansetron prophylaxis. Results : Urinary 5-HIAA excretion for a 24-hour period was increased in all patients after induction of cisplatin (P=0.002). Conclusion : Cisplatin chemotherapy is associated with serotonin release in the acute phase. Our finding may provide evidence for a relationship between emesis and serotonin following cisplatin chemotherapy.

• Journal of Oriental Neuropsychiatry
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• v.2 no.1
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• pp.3-18
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• 1991

Serotonin was chemically identified as 5-hydrowytryptamin which occurs in plants, animals, and human beings. The end product of metabolism was excreted as 5-HIAA in urine. Many scientists, specially biochemist and psychiatrist reported that the change of serotonin concentration caused mental disorder and pathological condiions such as schizophrenia and carcinoid. This study was carried out to observe the urinary 5-HIAA excretion rates changed by three recipes treatment (Kamisoyosan, Ondamtang, kalgunhaegitang) according to the classification of endogenous, exogenous and non-exo-endogenous, causes of disease. The urinary 5-HIAA excretion rates before and after three recipes treatment on normal groups divided into three groups on the basis of physical constitutional differences and on patients groups, divided into three groups according to the causal factor were measured. The results were as follows; 1. The urinary 5-HIAA volume of patients groups appeared non-exoendogenous, endogenous, exogenous causes of disease in order of three causative classification. 2. The urinary 5-HIAA volume of Normal groups was $2.50{\pm}088mg/24hrs$(range $0.30{\sim}6.90mg/24hrs$) 3. Thr urinary 5-HIAA volume was $3.70{\pm}0.89mg/24hrs$(range $0.90{\sim}6.50mg/24hrs$) before kamisoyosan treatment and $3.20{\pm}0.72mg/24hrs$ (range $0.80{\sim}6.20mg/24hrs$) after the treatment. 4. The value was $2.60{\pm}0.10mg/24hrs$ (range $0.60{\sim}6.50mg/24hrs$) before Ondamtange treatment and $2.00{\pm}0.12mg/24hrs$(range $0.20{\sim}6.10mg/24hrs$) after the treatment. 5. The value was $4.30{\pm}0.75mg/24hrs$(range $0.92{\sim}6.50mg/24hrs$) before kalgunhaegitang treatment and $3.10{\pm}0.10mg/24hrs$(range $0.80{\sim}5.80mg/24hrs$) after the treatment. Considering the above-mentioned the study on the changes of urinary 5-HIAA volume will make a significant contribution to the diagnosis and the evaluation of therapeutic effect successive research and modified application will be in need.

• The Korean Journal of Pharmacology
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• v.17 no.2
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• pp.47-62
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• 1981

d-amphetamine이 사람에서 paranoid schizophrenia와 아주 유사한 model psychosis를 일으키며 또한 사람과 실험동물에서 실제 정신분열증에서 뚜렷이 관찰되는 behavioral perservation을 일으킬 수 있음이 관찰되었다. 이에 많은 학자들은 이러한 양상의 행동변화가 정신분열증의 원인 추구에 중요한 의미를 주는 뇌변화를 반영할지도 모른다는 생각에 많은 연구를 거듭하여 왔다. 지금까지는 주로 catecholamine기전에 대하여 집중적 연구가 수행되어져 왔으나 최근에는 d-amphetamine의 약리기전의 일부는 5-HT기전이 차지하고 있으며, 여러 행동변화에는 catecholaimin 보다 5-HT 가 더 중요하게 관계하고 있다는 주장이 나오고 있다. 또한 d-amphetamine은 시험관내에서 MAO 특히 신경전달물질 분해요소인 A type를 가역적으로 억제할 수 있음이 보고되어 많은 흥미를 끌어왔으나 생체내에서의 억제여부는 직접적으로 확인이 되고 있지 않다. 그러나 최근에 Braestrup(1977)과 El Hait(1978)등은 간접적인 방법으로 생체내에서도 억제시킬 수 있음을 보고하고 있다. 이에 저자는 d-amphetamine에 의해 야기되는 행동변화와 그 밑바탕을 이루는 생화학적 기전에 5-HT가 차지하는 역할을 알아보기 위해서 다음의 실험을 시행하였다. 첫째, d-amphetamine의 급성, 만성 투여가 5-HT의 5-HIAA 로의 turnover와 MAO활성도에 어떤 영향을 미치며, 더 나아가서 이 양자사이에 어느 정도 상관관계가 있는지를 알아보기 위해서 d-amphetamine을 투여한 후 시간 경과에 따라서 뇌내 5-HT, 5-HIAA, 5-HT turnover rate와 MAO 활성도를 측정하였다. 둘째, d-amphetamine, 5-HT 합성을 증가시키는 약물과 합성을 억제시키는 약물을 투여하고, 위의 생화학적 실험과 행동관찰을 병합 실시하여 비교분석하였다. 그 결과는 다음과 같다. 1) d-amphetamine (6 mg/kg)을 급성투여시, 뇌내 5-HT함량이 투여 1시간 후에 최고로(대조치의 123%, p<0.001) 증가되다가 이후 감소하며, 5-HIAA 함량은 처음 15분부터 감소하기 시작하다가 30분에 최저로 떨어지며(대조치의 78%, p<0.005) 이후 증가하여 24시간째는 약간 대조치 이상으로 회복되었다. 미토콘드리아 MAO활성도는 1시간째에 최저로 떨어지다가(대조치의 89%, p<0.05)이후 회복하기 시작하여 24시간째에 약간 대조치 이상으로 회복되었다. 5-HT의 turnover rate는 MAO활성도 변화와 거의 같은 변화를 보였다. 2) 만성투여시 (하루 2번, 14일간 투여)는 5-HT 함량, 5-HIAA 함량, MAO 활성도 및 5-HT turnover rate 모두가 중등도로 감소되었다. (각각 대조치의 87%, 69%, 80%, 79%). 3) MAO 활성도와 5-HT turnover rate 사이에는 높은 상관관계가 있었다. (r=0.866, p<0.001, N=94). 4) MAO 활성도의 역동학 실험에서는 대조치에 비해 투여군에서 Km 값은 의미가 있는 증가가 있었으나 $V_{max}$값은 큰 변동이 없었다. 5) d-amphetamine을 급성 투여할때는 sleeping과 lying components는 상당한 감소를 보인 반면, locomotor activity 는 1시간까지는 상당한 증가를 보였으며 용량이 적을수록 더 큰 증가가 있었다. 반면 stereotypy는 1시간까지 용량이 증가할수록 더 큰 증가가 나타나서 locomotor activity에서 stereotypy 의 증가로 이행을 나타내었다. 만성 투여시는 locomotor activity는 점차적인 감소를 보였으나 stereotypy는 점차적인 증가가 나타나서 14일쯤에는 평형에 도달하였다. 6) PCPA 단독 투여군(400 mg/kg, 3번)에 있어서는 5-HT와 5-HIAA 함량의 상당한 감소가 나타났으나 MAO 활성도와 행동에는 큰 변화를 나타내지 않았다. PCPA전 처치군에 있어서도 5-HT와 5-HIAA 함량은 마찬가지로 상당한 감소를 나타내었으나 gnawing, sniffing과 locomotor activity는 더 증가를, stereotyped head weaving, forepaw treading과 hindlimb abduction은 상당한 감소를 나타내었다. 7) L-tryptophan(100 mg/kg)단독 투여시는 5-HT 함량은 약간 증가를 나타내었으나 5-HIAA 함량은 상당한 증가를 보였다. MAO활성도나 행동은 큰 변화없었다. L-tryptophan 전처치군에 있어서는 5-HT 함량은 더 큰 증가를 보였으나, 5-HIaa 함량은 MAO 활성도는 별 변화없었으며 stereotypedlateral head waving, forepaw treading 과 hindlimb abduction은 증가를, locomotor activity, gnawing과 sniffing components는 감소를 나타내었다. 8) d-amphetamine 단독투여, 혹은 L-tryptophan 전처치, PCPA 전처치후 측정한 5-HT 함량과 stereotyped head weaving, forepaw treading, hinilimb abduction components 사이에는 높은 상관관계가 있었다(r=0.789, p<0.001). 반면 5-HT 함량과 locomotor activity, stereotyped gnawing과 sniffing components 사이에는 약한 음성의 상관관계가 있었다. (r=0.554, p <0.005). 이상의 결과로 미루어 볼때 5-HT의 5-HIAA 로의 turnover rate 는 주로 MAO 활성도에 의해서 조절되며 5-HT 기전이 d-amphetamine에 의해서 야기된 여러 행동변화 중 상당한 부분에서 중요한 역할을 하리라고 생각된다.