Summary
One patient with agitated, 2 patients with inhibited endogenous depression, and 2 patients with Parkinson's disease were treated with tetrahydrobiopterin (BH4) in single oral doses of 0.9–1 g. Part of the clinical symptoms disappeared in the 2 patients with inhibited endogenous depression after 4–5 hours and the symptoms reappeared approximately 10 hours after the loading. In these two patients urinary free dopamine and serotonin increased from low to high normal values parallel to the clinical improvement. Both patients with Parkinson's disease lost their hypokinesia and rigidity and part of the tremor 4 hours after BH4 for a period of approximately 5 hours.
These observations support the theories that depression may be related to a relative lack of certain biogenic amine neurotransmitters and that Parkinson's disease is primarily related to the loss of dopamine neurons. Furthermore, the potential causal role of altered BH4 metabolism in certain cases of depression and Parkinson's disease should be considered. The administration of BH4 may also be of diagnostic importance in diseases related to altered biogenic amine metabolism.
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Curtius, H.C., Müldner, H. & Niederwieser, A. Tetrahydrobiopterin: Efficacy in endogenous depression and Parkinson's disease. J. Neural Transmission 55, 301–308 (1982). https://doi.org/10.1007/BF01243451
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DOI: https://doi.org/10.1007/BF01243451