Dopamine 

Updated: Nov 27, 2019
Author: Georges Elhomsy, MD, ECNU, FACE; Chief Editor: Eric B Staros, MD 

Reference Range

Dopamine is a monoamine neurotransmitter that belongs to the catecholamine family; the catecholamine family includes dopamine, norepinephrine, and epinephrine. Dopamine is mainly produced in the nervous system and adrenal medulla; it plays a role in many brain functions like behavior and cognition.

The plasma reference ranges for dopamine are as follows[1] :

  • Supine adults: < 10 ng/ml (conventional units); < 0.065 nmol/L (SI units)
  • Ambulatory adults: < 20 ng/mL (conventional units); < 0.13 nmol/L (SI units)
  • Age 3-15 years: < 60 pg/mL (conventional units); < 0.39 nmol/L (SI units)

The urinary reference range for dopamine in adults and elderly persons is 65-400 mcg/24 hr.[2]

The urinary reference ranges for dopamine in children are as follows[2] :

  • 0-1 year: 0-85 mcg/24 hr
  • 1-2 years: 10-140 mcg/24 hr
  • 2-4 years: 40-260 mcg/24 hr
  • >4 years: 65-400 mcg/24 hr
 

Interpretation

Catecholamines including dopamine may be elevated in the following instances:

  • After a medication withdrawal (eg, clonidine, alcohol)

  • In acute illness

  • With medications such as tricyclic antidepressants, buspirone, antipsychotic agents, cocaine, Levodopa, amphetamines, ephedrine, pseudoephedrine[3]

 

Collection and Panels

Plasma

Patient instructions are as follows:

  • The patient should fast for at least 4 hours and should avoid smoking and caffeinated beverages.

  • Medication that interfere with catecholamines metabolism should be avoided if possible.

Specimen collection instructions are as follows:

  • An indwelling intravenous catheter should be used.

  • After catheter insertion, the patient should rest for 30 minutes in the supine position.

  • Withdraw the blood specimen afterward.

Collection tube - Lavender-top tube or green-top tube

Specimen preparation - Separate plasma from cells and transfer to transport tube in less than 1 hour and freeze immediately.

Storage/transport temperature - Frozen

Stability - Frozen (14 days)

Unacceptable conditions - Grossly hemolyzed specimens

Panels - Plasma fractionated catecholamines that include plasma dopamine, epinephrine, and norepinephrine

Urine

Patient instructions are as follows:

  • Medication that interfere with catecholamines metabolism should be stopped at least a week prior to the urine collection if possible.

Specimen collection - 24-hour urine collection, creatinine measurement on the same urine sample to assess the specimen adequacy

Collection container - Urine container with 25 mL 6N HCl preservative.

Specimen preparation: Separate plasma from cells and transfer to transport tube in less than 1 hour and freeze immediately.

Storage/transport temperature: Refrigerate during and after collection.

Stability - Room temperature: 3 days, refrigerated: 14 days, frozen: 14 days

Unacceptable conditions - A container with pH greater than 5

Panels - Catecholamines fractionation (free), 24-hour urine including urine dopamine, epinephrine, and norepinephrine

 

Background

Description

Dopamine is a monoamine neurotransmitter that belongs to the catecholamine family; the catecholamine family includes dopamine, norepinephrine, and epinephrine. Dopamine is mainly produced in the nervous system and adrenal medulla; it plays a role in many brain functions like behavior and cognition.[4, 5]

Tyrosine hydroxylase converts tyrosine to 3,4-dihydroxyphenylalanine (DOPA), which is converted to dopamine under the effect of aromatic l-amino acid decarboxylase, then dopamine β-hydroxylase converts dopamine to norepinephrine and phenylethanolamine N -methyltransferase converts norepinephrine to epinephrine.[6]

Indications/Applications

Plasma and/or urine dopamine tests are indicated as part of the work up for the diagnosis of the following conditions:

  • Pheochromocytoma

  • Paraganglioma

  • Neuroblastoma

Plasma and/or urine dopamine can be used in the monitoring of the following conditions:

  • Adrenal incidentaloma

  • Neuroblastoma after therapy

Plasma fractionated catecholamines includes plasma dopamine, epinephrine, and norepinephrine, whereas 24-hour urine fractionated catecholamine includes urine dopamine, epinephrine, and norepinephrine.

In cases of pheochromocytoma, adrenal incidentaloma, and paraganglioma, plasma and urine dopamine must not be measured separately; rather, plasma fractionated catecholamines and 24-hour urine fractionated catecholamine should be ordered since rarely will pheochromocytomas and paragangliomas only secrete dopamine.

The most acceptable approach for pheochromocytoma diagnosis is to screen with 24-hour urine collection for fractionated metanephrines and catecholamines; if high clinical suspicion exists, then plasma fractionated metanephrines should then follow as a confirmatory test.

During the work-up for neuroblastoma, dopamine, whether in the urine or the plasma, should be measured in combination with 24-hour urine vanillylmandelic acid (VMA) and homovanillic acid (HVA).