Increased activity of creatine phosphokinase and aldolase activity in the acute psychoses: Case reports

Two acutely psychotic patients, one a manic-depressive, the other and acute schizophrenic, who both had marked increases in the activity of creatine phopphokinase (CPK) and aldolase in serum are presented and discussed. The increases in serum enzyme activity were significantly correlated with clinical course, occuring at times of severe stress which preceded or coincided with psychotic behavior. The type of CPK and aldolase present was the muscle type. No increase in CPK and aldolase activity in spinal fluid was noted. Some of the factors which might be expected to effect serum CPK and aldolase activity were considered: physical activity, catecholamines, secretion of steroids, medication and weight loss. These factors do not appear to account for the increased activity of CPK and aldolase. The increased enzyme activity is discussed as a manifestation of subtle myopathic changes in acutely psychotic patients.