Prediction of improvement by use of epinephrine-methacholine (mecholyl) test; study of immediate response in twenty-six treated patients and one-year follow-up of forty-eight treated patients.

Introduction There has long been a search for a physiological test which would predict response to therapy in psychiatric disease. Gold, 1 in 1943, and, later, Funkenstein 2-7 described such a test. The test as usually described consists of following the blood pressure response to either epinephrine and methacholine (Mecholyl), given at different times, preferably on different days, or to methacholine alone. On the basis of the blood pressure response to these drugs, patients may be divided into two categories: those with favorable and those with unfavorable prognosis. Because of the importance of having a physiological test of predictive value, I decided to extend the studies thus far reported by repeating the original ones and by a long-term study, which, as far as I know, is the first such investigation reported. Procedure and Results Attempt at Confirmation of the Epinephrine-Methacholine Test In an effort to evaluate the autonomic test described