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Effects of a branched-chain amino acid drink in mania

  • A. Scarnà (a1), H. J. Gijsman (a1), S. F. B. Mctavish (a1), C. J. Harmer (a1), P. J. Cowen (a1) and G. M. Goodwin (a1)...

Abstract

Background

Administration of a complex tyrosine-free amino acid drink acutely decreases manic symptoms. Although a nutrient-based approach to illness management is attractive, complex amino acid drinks are too unpalatable for repeated administration.

Aims

To assess whether a simple, branched-chain amino acid (BCAA) drink diminishes manic symptoms acutely and following repeated administration.

Method

Twenty-five patients with mania were randomly and blindly allocated to treatment with BCAA (60 g) or placebo daily for 7 days.

Results

Relative to placebo, the BCAA drink lowered mania ratings acutely over the first 6 h of treatment. In protocol completers there was a persistent advantage to the BCAA group 1 week after the end of treatment.

Conclusions

A nutritional intervention that decreases tyrosine availability to the brain acutely ameliorates manic symptoms. Further studies are required to assess whether this approach has longer-term efficacy.

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Copyright

Corresponding author

Dr A. Scarnà, Neurosciences Building, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Tel: 01865 226492; e-mail: anna.scarna@psych.ox.ac.uk

Footnotes

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Declaration of interest

This study was funded by the Wellcome Trust; P.J.C. is a Medical Research Council (MRC) Clinical Scientist, S.F.B.M. is an MRC Clinician Scientist Fellow and C.J.H. is an MRC Training Fellow.

Footnotes

References

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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Beigel, A. & Murphy, D. L. (1971) Assessing clinical characteristics of the manic state. American Journal of Psychiatry, 128, 688694.
Gijsman, H. J., Scarna, A., Harmer, C. J., et al (2002) A dose-finding study on the effects of branch chain amino acids on surrogate markers of brain dopamine function. Psychopharmacology, 160, 192197.
Grevet, E. H., Tietzmann, M. R., Shansis, F. M., et al (2002) Behavioural effects of acute phenylalanine and tyrosine depletion in healthy male volunteers. Journal of Psychopharmacology, 16, 5155.
Jacobs, D. & Silverstone, T. (1986) Dextroamphetamine-induced arousal in human subjects as a model for mania. Psychological Medicine, 16, 323329.
McTavish, S. F. B. & Cowen, P. J. (1999) Effect of a tyrosine-free amino acid mixture on regional brain catecholamine synthesis and release. Psychopharmacology, 141, 182188.
McTavish, S. F. B., McPherson, M. H., Harmer, C. J., et al (2001) Antidopaminergic effects of dietary tyrosine depletion in healthy subjects and patients with manic illness. British Journal of Psychiatry, 179, 356360.
Montgomery, J. A., McTavish, S. F. B., Cowen, P. J., et al (2002) PET measurement of the effect of dietary tyrosine depletion on [11C]raclopride binding. Journal of Psychopharmacology, 16, A42.
Richardson, M. A., Bevans, M. L., Weber, J. B., et al (1999) Branched chain amino acids decrease tardive dyskinesia symptoms. Psychopharmacology, 143, 358364.
Scarnà, A., Gijsman, H. J., Harmer, C. J., et al (2001) Effects of a branch chain amino acid drink supplemented with tryptophan on surrogate markers of brain dopamine function. Journal of Psychopharmacology, 15, A14.
Scarnà, A., Gijsman, H. J., Harmer, C. J., et al (2002) Effects of a branch chain amino acid supplemented with tryptophan on tyrosine availability and plasma prolactin. Psychopharmacology, 159, 222223.
Tohen, M., Jacobs, T. G., Grundy, S. L., et al (2000) Efficacy of olanzapine in acute bipolar mania. Archives of General Psychiatry, 57, 84849.
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Effects of a branched-chain amino acid drink in mania

  • A. Scarnà (a1), H. J. Gijsman (a1), S. F. B. Mctavish (a1), C. J. Harmer (a1), P. J. Cowen (a1) and G. M. Goodwin (a1)...

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Effects of a branched-chain amino acid drink in mania

  • A. Scarnà (a1), H. J. Gijsman (a1), S. F. B. Mctavish (a1), C. J. Harmer (a1), P. J. Cowen (a1) and G. M. Goodwin (a1)...
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