l-Tryptophan in hyperactive child syndrome associated with epilepsy: a controlled study

The effect of l-tryptophan in childhood hyperkinesia was compared with placebo tablets in 11 epileptic boys, aged 7-14 years, in a residential school for epileptics. The mean age of epilepsy was 2.5 years, and the duration of hyperactivity varied between 1.3 and 5.5 years. They were receiving either carbamazepine or sodium valproate alone, or combinations of both drugs for epilepsy. The investigation was designed as a double-blind cross-over study in which the patients were selected randomly to receive either l-tryptophan (40 mg/kg body weight) or matched placebo tablets first. Each treatment phase lasted for 5 weeks and the alternative medication was given after a 3-week washout period. Concomitant antiepileptic drugs were kept unaltered and no other drug was prescribed during the study. The patients were assessed at the pre-entry period (basal) and at the end of each treatment phase by their teachers and child care staff. The rating scale used included Connor's teacher and parent rating scales, the Meanwood Park Hospital behaviour scale, and visual analogue scales. A record of the patients' seizure frequency was kept throughout the investigation. Plasma antiepileptic drug levels were monitored at the end of each phase and they were virtually identical during these two treatment periods. In the dosage used, l-tryptophan was tolerated well by these children, and seizure frequency, as a whole, remained unaltered. However, no significant beneficial effect on their behaviour was observed during 5 weeks of l-tryptophan therapy.