Manipulation of Cerebral Monoamines in the Treatment of Human Epilepsy: A Pilot Study

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Abstract
The effects of L-dopa, L-tryptophan, monoamine oxidase inhibitor (MAOI) and MAOI plus L-tryptophan, each for 3 mo., were assessed in 10 severe, adult epileptics with placebo control. There was no overall reduction in seizure frequency, but 2 patients with minor partial seizures improved, 1 with L-dopa, MAOI, and MAOI plus L-tryptophan, and the other with L-tryptophan and MAOI plus L-tryptophan. An increased turnover of cerebral serotonin (5-HT [5-hydroxytryptamine]), as measured by CSF 5-hydroxyindoleacetic acid, was not demonstrated after treatment with L-tryptophan for 3 mo. This observation casts doubt on the ability of L-tryptophan to alter the long-term metabolism and functional activity of brain 5-HT. The importance of further exploration of manipulation of cerebral monoamines as a possible approach to the treatment of epilepsy was emphasized.