Changes in Urinary Uric Acid-Creatinine Ratio After Electrically Induced Convulsions in Man

RECENT studies have provided evidence indicating that increased secretion of adrenal cortical steroid hormones occurs in patients given electroconvulsive therapy for mental disease (1–7). Changes in the uric acid-creatinine ratio four hours after the injection of adrenocorticotropic hormone (ACTH) has been suggested as a measure of adrenal cortical function (8) (9) and accordingly it was considered desirable to measure this ratio in patients given electroshock therapy. Fifteen studies were made on 9 women who were given electroconvulsive therapy for mental disease. The ages ranged between 25 and 73 years and the diagnoses varied (Table 1). The patients voided an hour and a half before the treatment; this urine sample was discarded and another sample was obtained immediately before shock was administered. Thereafter, samples were collected four hours after the treatment and whenever possible at the end of two hours also. In addition, some of the patients voided at other times during the four hours after shock was given; some of these samples of urine were obtained and the times at which they were voided were recorded. In other instances, however, specimens were lost, since the patients, psychotic to begin with and confused after the treatment, voided without attracting the attention of a nurse. In 7 of the 15 experiments all samples of urine voided during the first four hours after shock were collected at intervals accurately recorded; in these 7 instances calculation of hourly excretion of uric acid and of creatinine was possible. In all 15 studies the uric acid-creatinine ratio was calculated from measurements of the concentrations of these two substances in the samples of urine obtained.