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L-tryptophan and the eosinophilia-myalgia syndrome

Drugs and Therapeutics Bulletin (1990), 28, 37–38

Published online by Cambridge University Press:  02 January 2018

Philip J. Cowen
Philip J. Cowen*
Affiliation:
MRC Unit of Clinical Pharmacology and University Department of Psychiatry, Littlemore Hospital, Oxford OX4 4XN
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Eosinophilia-myalgia syndrome (EMS) is an alarming illness, occasionally fatal, which is characterised by severe myalgia, arthralgia, fatigue and, it now appears, ingestion of L-tryptophan (Hertzman et al, 1990). At first sight this appears rather surprising because tryptophan is, of course, present in the normal diet, albeit in smaller quantities (about 750 mg daily), than that usually prescribed for the treatment of depression (about 3 g daily). Furthermore, L-tryptophan has been available in the UK for the treatment of depression for over 20 years without previous cases of EMS coming to light, despite the dramatic nature of the symptomatology. All this suggests that a contaminant in the preparation of synthetic L-tryptophan could be responsible for the development of EMS, a view strengthened by the resemblance of EMS to the toxic oil syndrome which was caused by contaminated olive oil.

Type
Expert Opinion
Information
Psychiatric Bulletin , Volume 14 , Issue 12 , December 1990 , pp. 738 - 739
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1990

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