Mania: Sympathoadrenal function and clinical state

Alan C. Swann, Steven K. Secunda, Stephen H. Koslow, Martin M. Katz, Charles L. Bowden, James W. Maas, John M. Davis, Eli Robins

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


We investigated sympathoadrenal and sympathetic nervous system activity, catecholamine disposition, and clinical state in 19 hospitalized manic patients. Severity of the core manic syndrome, anxiety, and hostility correlated with 24-hour urinary excretion of epinephrine relative to its metabolites, but only weakly with norepinephrine. Agitation, however, correlated most strongly and significantly with norepinephrine. Eight of the patients had mixed states: concurrent manic and depressive syndromes. There were no differences between mixed and pure manic patients with respect to catecholamine or metabolite excretion or precursor/product ratios, but mixed manic patients tended to have higher excretion of norepinephrine and had increased variance with respect to catecholamine measures. These data suggest that the function of the adrenal medulla, whether directly or indirectly, is important in the symptoms of both mixed and pure mania.

Original languageEnglish (US)
Pages (from-to)195-205
Number of pages11
JournalPsychiatry Research
Issue number2
StatePublished - May 1991


  • Mania
  • behavior
  • epinephrine
  • mixed affective state
  • norepinephrine

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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