CSF norepinephrine concentrations in posttraumatic stress disorder

Am J Psychiatry. 2001 Aug;158(8):1227-30. doi: 10.1176/appi.ajp.158.8.1227.


Objective: Despite evidence of hyperresponsive peripheral and central nervous system (CNS) noradrenergic activity in posttraumatic stress disorder (PTSD), direct measures of CNS norepinephrine in PTSD have been lacking. The goal of this study was to determine serial CSF norepinephrine levels in patients with PTSD.

Method: CSF samples were obtained serially over a 6-hour period in 11 male combat veterans with chronic PTSD and eight healthy men through an indwelling subarachnoid catheter. Thus the authors were able to determine hourly CSF norepinephrine concentrations under baseline (unstressed) conditions. Severity of the patients' PTSD symptoms was assessed with the Clinician-Administered PTSD Scale.

Results: CSF norepinephrine concentrations were significantly higher in the men with PTSD than in the healthy men. Moreover, CSF norepinephrine levels strongly and positively correlated with the severity of PTSD symptoms. Plasma norepinephrine concentrations showed no significant relationship with the severity of PTSD symptoms.

Conclusions: These findings reveal the presence of greater CNS noradrenergic activity under baseline conditions in patients with chronic PTSD than in healthy subjects and directly link this pathophysiologic observation with the severity of the clinical posttraumatic stress syndrome.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Analysis of Variance
  • Catheters, Indwelling
  • Chromatography, High Pressure Liquid
  • Circadian Rhythm
  • Headache Disorders
  • Humans
  • Male
  • Middle Aged
  • Norepinephrine / cerebrospinal fluid*
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Spinal Puncture / methods
  • Stress Disorders, Post-Traumatic / cerebrospinal fluid*
  • Stress Disorders, Post-Traumatic / diagnosis
  • Subarachnoid Space


  • Norepinephrine