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Schizophrenia Bulletin 1998 24(3):391-397;
© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

Higher Cerebrospinal Fluid Angiotensin-Converting Enzyme Levels in Neuroleptic-Treated Than in Drug-Free Patients With Schizophrenia

Kristian Wahlbeck, M.D., Ph.D., Antti Ahokas, M.D., Ph.D., Kati Miettinen, M.D., Heikki Nikkilä, M.D. and Ranan Rimón, M.D., Ph.D.
Senior Lecturer, Department of Psychiatry, University of Helsinki Helsinki, Finland
Assistant Chief Physician, Hesperia Hospital Helsinki, Finland
Resident in Psychiatry, Department of Psychiatry, University of Helsinki Helsinki, Finland
Chief of Psychiatry, Institute of Occupational Health Helsinki, Finland
Professor and Chairman, Department of Psychiatry, University of Helsinki Helsinki, Finland

Reprint requests should be sent to Dr. K. Wahlbeck, Dept. of Psychiatry, University of Helsinki, Lappviksvägen, FIN-00180 Helsinki, Finland

The aim of this study was to replicate our earlier finding of elevated angiotensin-converting enzyme (ACE) in cerebrospinal fluid (CSF) in schizophrenia and to elucidate the role of neuroleptic treatment in this phenomenon. Drug-free and medicated patients with acute schizophrenic psychoses, as well as healthy controls were recruited. Levels of ACE were measured in CSF and serum from 7 drug-free patients, 36 neuroleptic-treated patients, and 19 healthy control subjects. Although ACE levels in CSF did not differ between patients and controls, the drug-free patients showed significantly lower levels than the neuroleptic-treated patients. Serum ACE did not differ between groups. The elevation of CSF ACE may be more prominent in patients with deficit symptoms than in those with mainly psychotic symptoms.

The possible enhancement of CSF ACE production or solubility by neuroleptic treatment is discussed. Elevated ACE levels in CSF may, together with other possible factors, cause polydipsia, stimulate secretion of arginine vasopressin, and even affect neuron growth and differentiation in schizophrenic psychoses.

Keywords: Renin-angiotensin system / angiotensin-converting enzyme / cerebrospinal fluid / neuroleptics


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