Treatment of pathologic emotionality with thyrotropin-releasing hormone

Thyrotropin-releasing hormone (TRH) has been reported to be effective in some neuropsychiatric diseases. We examined the effect of TRH on the syndrome of pathologic laughing or crying in four patients with multiple cerebral infarction and one with olivo-ponto-cerebellar atrophy (OPCA). We found a marked therapeutic effect of the peptide on pathologic laughing with a slight improvement in ataxia in a patient with OPCA. A marked diminution in frequency of their pathologic crying with TRH was achieved in two patients with multiple cerebral infarction. The two other patients did not respond to TRH. Levodopa was administered to these patients to compare with TRH in therapeutic efficacy on the symptom and was effective in only one of four patients. The concentration of homovanillic acid in cerebrospinal fluid had diminished in two of the four patients. The results suggest that the tripeptide is effective in the control of this syndrome. We discuss the underlying mechanism(s) of the syndrome and the mode(s) of action of TRH.