SEROTONIN METABOLISM IN LIVER DISEASE*

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Abstract
5-Hydroxytryptophan(5-HTP), 10 to 40 mg, was administered intravenously to 9 patients while eegs were recorded. In all 5 patients with hepatic coma, the record was altered in the direction of normal. In 3 patients with coma, not due to liver failure, and in 1 normal individual, there were no alterations in the eeg. Twenty-four hour urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) accounted for 52% of the 5-hydroxy-L-tryptophan administered. No definite defect was observed in the ability of patients with liver disease to metabolize 5-hydroxytryptophan as compared with a control group. At the dosage levels utilized, infused 5-hydroxytryptophan produced no effect on blood serotonin. In patients with hepatic insufficiency, there was no change in tremors, mental confusion or reflex activity. Abdominal discomfort and increased peristalsis were frequent.