The metabolic disturbances of monoamine in the hypothalamic-pituitary-adrenal axis (HPA axis) was examined in patients with chronic schizophrenia showing nonsuppression of the dexamethasone suppression test (DST). Subjects were 16 male chronic schizophrenics consisting of 8 DST suppressors and 8 nonsuppressors. All the patients were orally given the 5HT precursor, L-5-hydroxytryptophan (L-5HTP, 3 mg/kg) and the α2-adrenergic agonist, clonidine (3 μg/kg), and the concentrations of plasma prolactin, cortisol, human growth hormone, and blood 5HT were measured chronologically. As a result, all of the DST nonsuppressors showed no increased response of prolactin after L-5HTP loading. Moreover, in the DST nonsuppressors, the secretion response of cortisol after L-5HTP loading was delayed compared with that of the suppressors. However, no different response between the DST suppressors and the nonsuppressors was observed after a loading dose of clonidine. These results suggest that there might be a metabolic disturbance of 5HT in the HPA axis of chronic schizophrenics showing DST nonsuppression.

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