[Medical treatment of hyperammoniemia in the elderly. Controlled clinical study]

After considering the physiopathological mechanisms of ammoniac metabolism and the different causes of hyperammonaemia in subjects whose organisms present the weak biological equilibrium of the elderly, the antiammonaemic activity of gamma-ethylester of glutamic acid and that of arginine have been compared in a controlled double-blind trial. 45 old patients suffering from hepatic insufficiency characterized by hyperammonaemia and correlated neurological symptomatology have been treated. The subjects, subdivided at random into groups of 15, were treated for an average of 8.8 days with gamma-ethylester of glutamic acid, arginine and placebo presented in identical 500 ml bottles. The posology of the active ingredients ranged form a maximum of 25 g to a minimum of 10 g. The results obtained show that gamma-ethylester of glutamic acid and arginine has significantly greater antiammonemic activity than placebo and that gamma-ethylester of glutamic acid is significantly more effective than arginine. As regards the improvement in neuropsychic symptomatology, the clear superiority of gamma-ethylester of glutamic acid versus both arginine and placebo non evident.