Biochemical investigations into the alcoholic delirium: alterations of biogenic amines

In eight male patients with alcoholic delirium concentrations of 3-methoxy-4-hydroxyphenylglycol (MHPG) and homovannilic acid (HVA) in CSF, activity of dopamine-beta-hydroxylase (DBH) and urinary excretion of noradrenaline (NA), adrenaline (A), and dopamine (DA) were measured during the delirium and a drug-free control period. MHPG concentration in CSF, excretion of NA and A as well as activity of serum DBH were significantly elevated during the delirium phase as compared to the control period. Urinary DA excretion and HVA in CSF did not show any constant changes. There was a positive correlation (r = 0.64) between DBH activity and the intensity of the delirium (as measured on the delirium rating scale). It is hypothesized that there is a relationship between alcoholic delirium and increased central noradrenergic activity.