A disturbance of serine-glycine metabolism has been demonstrated in patients suffering from episodic acute psychosis, characterized by sensory perceptual distortions in whom oral loading with either serine or glycine induced psychedelic symptoms. Fasting plasma amino acid levels in oral serine-responsive patients were compared with those in glycine-responsive and manic-depressive patients. Only serine-responsive patients had a decreased plasma serine and increased plasma taurine concentration, while glycine responsive patients showed decreased alanine and manic-depressive patients an increased plasma glycine level. Amino acid analyses of plasma samples obtained after serine loading in patients and controls suggest that serine-responsive patients had an impaired conversion of glycine into serine. The results suggest that the higher plasma taurine level in serine-responsive patients is caused by an increased synthesis of taurine from homocysteine and serine. The limiting capacity of methyltetrahydrofolate-homocysteine methyltransferase coupled to increased formation of taurine may be responsible for the serine-evoked psychotic syndrome.