Circadian variation in plasma homovanillic acid level during and after alcohol withdrawal in alcoholic patients.

Alcohol withdrawal symptoms in alcoholics were objectively evaluated and classified into three groups according to the severity of their symptoms, and circadian variation in their plasma homovanillic acid (HVA) concentrations was determined at three different intervals after cessation of drinking. The subjects studied were 19 male alcoholic patients and five age-matched healthy male volunteers. Circadian variation in plasma HVA was compared between each patient group and the control group by two-way ANOVA. In the sympathetic overactivity (SO) group comprising nine patients and in the clouding of sensorium (CS) group comprising five patients, plasma HVA concentrations on the 2nd and 3rd day and on the 6th and 7th day after cessation of drinking were low but recovered almost normal levels on the 21st and 22nd postcessation day. The delirium tremens group (DT) comprising five patients, however, showed significantly higher plasma HVA than the control group except on the 6th and 7th postcessation day. The higher plasma HVA in the DT group indicates that there is some sort of preparatory state whereby dopamine metabolism is involved in the appearance of hallucinations at alcohol withdrawal and can possibly be used as a predictor of otherwise hardly predictable delirium tremens.