Altered mood and norepinephrine metabolism following withdrawal from alcohol

Affective symptoms were evaluated in chronic alcoholics during a 2-week period following detoxification from alcohol. Increased ratings were apparent both on the Manic State Rating Scale (MSRS) and on the Ma Scale of the Minnesota Multiphasic Personality Inventory (MMPI) in a subgroup of these patients. Primary symptoms included grandiosity, irritability, and mildly increased psychomotor activity. Alcoholics who had been detoxified for several months or hospitalized medical patients did not show similar symptoms. Measurements of urinary 3-methoxy-4-hydroxyphenylethylene glycol (MHPG), a metabolite of norepinephrine which has been associated with manic-depressive illness, also showed increased excretion in a subpopulation of recently detoxified patients. The coexistence of depressed mood in these patients may have led to symptoms of hypomania being previously overlooked, although signs of depression are common in mania itself.