Severity of withdrawal symptoms from alcohol was quantified in alcoholics admitted to the Neurology Ward of the Washington, D.C. VA Hospital. Cerebrospinal fluid (CSF) samples were repeatedly obtained early during withdrawal and after all symptoms had subsided. Concentrations of the monoamine neurotransmitter norepinephrine and its major metabolite MHPG were measured at NIH. Significant positive correlations were observed between indices of elevated norepinephrine turnover and several signs of alcohol withdrawal. We are continuing this work trying to identify causes for the noradrenergic dysregulation during alcohol withdrawal. Thus, we are measuring peptides known to synapses simultaneously with norepinephrine. We are correlating norepinephrine and MHPG in the CSF and to the severity of withdrawal symptoms in our patients. We are continuing to increase our sample size. Our new mass spectrometric method to quantify glandius has shown that the concentrations of prostaglandins in human lumbar CSF are negligible. Thus, previous quantification by radioimmunoassays are probably erroneous.
