Manipulation of brain serotonin in the treatment of myoclonus

Lancet. 1975 Sep 6;2(7932):434-5. doi: 10.1016/s0140-6736(75)90846-6.

Abstract

The response of myoclonus to oral and intravenous L-5-hydroxytryptophan (5-H.T.P.) in combination with a peripheral decarboxylase inhibitor (carbidopa) and to clonazepam has been examined in 9 patients. Moderate improvement or complete cessation of myoclonus followed treatment with one or both of these regimens in 5 patients, 1 of whom also responded to the concurrent administration of L-tryptophan and a monoamineoxidase inhibitor. The remaining 4 patients were at best only slightly improved by either 5-H.T.P. or clonazepam. The responsive group consisted of 3 patients with a history of anoxia, 1 patient with non-history of severe head injury, and 1 patient with non-progressive focal myoclonus and epilepsy. This group had low levels of 5-hydroxyindole acetic acid in the lumbar cerebrospinal fluid. It is suggested that 5-H.T.P. plus carbidopa, L-tryptophan plus a monoamine-oxidase inhibitor, and clonazepam may all act by elevating brain levels of serotonin (5-H.T.) and that some human myoclonic syndromes may be specifically related to a cerebral deficiency of 5-H.T.

MeSH terms

  • 5-Hydroxytryptophan / administration & dosage
  • 5-Hydroxytryptophan / therapeutic use
  • Administration, Oral
  • Adult
  • Aged
  • Benzodiazepinones / therapeutic use*
  • Brain / metabolism*
  • Carbidopa / administration & dosage
  • Carbidopa / therapeutic use*
  • Clonazepam / administration & dosage
  • Clonazepam / therapeutic use*
  • Drug Evaluation
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydrazines / therapeutic use*
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Myoclonus / drug therapy*
  • Myoclonus / metabolism
  • Serotonin / metabolism*

Substances

  • Benzodiazepinones
  • Hydrazines
  • Serotonin
  • Clonazepam
  • 5-Hydroxytryptophan
  • Carbidopa