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Effect of L-Tryptophan on Spasmodic Torticollis

Published online by Cambridge University Press:  18 September 2015

S. Lal*
Affiliation:
Departments of Psychiatry and Neurology, McGill University, the Department of Psychiatry, Montreal General Hospital, the Allan Memorial Institute and the Douglas Hospital Research Centre
S.N. Young
Affiliation:
Departments of Psychiatry and Neurology, McGill University, the Department of Psychiatry, Montreal General Hospital, the Allan Memorial Institute and the Douglas Hospital Research Centre
M.E. Kiely
Affiliation:
Departments of Psychiatry and Neurology, McGill University, the Department of Psychiatry, Montreal General Hospital, the Allan Memorial Institute and the Douglas Hospital Research Centre
K. Hoyte
Affiliation:
Departments of Psychiatry and Neurology, McGill University, the Department of Psychiatry, Montreal General Hospital, the Allan Memorial Institute and the Douglas Hospital Research Centre
D.W. Baxter
Affiliation:
Departments of Psychiatry and Neurology, McGill University, the Department of Psychiatry, Montreal General Hospital, the Allan Memorial Institute and the Douglas Hospital Research Centre
T.L. Sourkes
Affiliation:
Departments of Psychiatry and Neurology, McGill University, the Department of Psychiatry, Montreal General Hospital, the Allan Memorial Institute and the Douglas Hospital Research Centre
*
Department of Psychiatry, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4
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The effect of L-tryptophan, a precursor of serotonin, and placebo were studied in eight patients with spasmodic torticollis. L-Tryptophan (5gpo as a single dose) which increased free plasma tryptophan 20-53 fold improved only one out of six patients. Two out of three patients, including the subject who improved following an oral load of tryptophan, improved with L-tryptophan combined with nicotinamide, a tryptophan pyrrolase inhibitor, when administered for 1-3 weeks. However, the magnitude of clinical improvement was not impressive. Our findings suggest that impairment of serotonergic function is not a general finding in spasmodic torticollis though it may play a minor role in the manifestation of this movement disorder in some patients. The present study emphasizes some of the difficulties in evaluating therapeutic response, namely, the intrinsic variability of the disorder, the response to placébo in some subjects and the limitations of methods for measuring change.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1981

References

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