Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-06-02T05:04:00.913Z Has data issue: false hasContentIssue false

17 - Pharmacological interventions for neurodevelopmental disorders

Published online by Cambridge University Press:  13 August 2009

By
Thomas Owley
Edited by
Scott J. Hunter  and
Jacobus Donders
Scott J. Hunter
Affiliation:
University of Chicago
Jacobus Donders
Affiliation:
Mary Free Bed Rehabilitation Hospital, Grand Rapids
Get access

Summary

The neurodevelopmental disorders can be broadly defined as any central nervous system disease process that hinders the ability of a child to achieve age-appropriate developmental maturity as expected (Farmer, Donders & Warchausky, 2006; Hagerman, 1999). Such disorders may have a variety of etiological underpinnings, including ones that are primarily genetic or metabolic in their onset. Some examples of neurodevelopmental disorders include the Autism Spectrum Disorders (ASDs), mucopolysaccharidoses, Fragile X Syndrome, Down Syndrome, neurofibromatosis, velo-cardio-facial syndrome, Turner Syndrome, among others that are less commonly known (Hagerman, 1999; also see Klein-Tasman, Philips & Kelderman, this volume). Behavioral difficulties that can be the target of pharmacological intervention are common in these disorders. In this chapter, concepts relevant to the pharmacological treatment of neurodevelopmental disorders will be explored. The autism spectrum disorders will be used as a model, to look at how decisions are made with regard to pharmacological interventions for children with these disorders.

ASD as a model neurodevelopmental disorder

The Autism Spectrum Disorders (ASDs) are a group of debilitating neurodevelopmental disorders characterized by (1) deficits in socialization; (2) deficits in language and communication; and (3) the presence of restricted, repetitive, and stereotyped patterns of behaviors, interests, and activities (American Psychiatric Association, 2000; see also Wolf, Fein & Akshoomoff, this volume). These disorders are best defined by the social difficulties that present in affected children.

Type
Chapter
Information
Pediatric Neuropsychological Intervention , pp. 369 - 391
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aman, M. G. & Kern, R. A. (1989). Review of fenfluramine in the treatment of the developmental disabilities. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 549–65.CrossRefGoogle ScholarPubMed
Aman, M. G., Kern, R. A., Arnold, L. E. & McGhee, D. E. (1991). Fenfluramine and mental retardation. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 507–8.CrossRefGoogle ScholarPubMed
Aman, M. G., Lam, K. S. & Bourgondien, M. E. (2005). Medication patterns in patients with autism: temporal, regional, and demographic influences. Journal of Child and Adolescent Psychopharmacology, 15, 116–26.CrossRefGoogle ScholarPubMed
Aman, M. G., Singh, N. N., Stewart, A. W. & Field, C. J. (1985). The Aberrant Behavior Checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 39, 485–91.Google Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders – Text Revision (DSM-IV-TR), 4th edn. Washington, DC: American Psychiatric Association Press, Inc.
Anderson, L. T., Campbell, M., Adams, P.et al. (1989). The effects of haloperidol on discrimination learning and behavioral symptoms in autistic children. Journal of Autism and Developmental Disorders, 9, 227–39.CrossRefGoogle Scholar
Anderson, L. T., Campbell, M., Grega, D. M.et al. (1984). Haloperidol in the treatment of infantile autism: Effects on learning and behavioral symptoms. American Journal of Psychiatry, 141, 1195–202.Google ScholarPubMed
Barber, J., Cross, I., Douglas, F.et al. (1998). Neurofibromatosis pseudogene amplification underlies euchromatic cytogenetic duplications and triplications of proximal 15q. Human Genetics, 103, 600–7.CrossRefGoogle ScholarPubMed
Birmaher, B., Quintana, H. & Greenhill, L. L. (1988). Methylphenidate treatment of hyperactive autistic children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 248–51.CrossRefGoogle ScholarPubMed
Brent, D. A., Crumrine, P. K., Varma, R. R., Allan, M. & Allman, C. (1987). Phenobarbital treatment and major depressive disorder in children with epilepsy. Pediatrics, 80, 909–17.Google ScholarPubMed
Buitelaar, J. K., Willemsen-Swinkels, S. & Engeland, H. (1998). Naltrexone in children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 800–02.CrossRefGoogle ScholarPubMed
Campbell, M., Adams, P., Perry, R., Spencer, E. K. & Overall, J. E. (1988). Tardive and withdrawal dyskinesia in autistic children: A prospective study. Psychopharmacology Bulletin, 24, 251–5.Google ScholarPubMed
Campbell, M., Anderson, L., Small, A., Adams, P., Gonzalez, N. & Ernst, M. (1993). Naltrexone in autistic children: Behavioral symptoms and attentional learning. Journal of the American Academy of Child and Adolescent Psychiatry, 32(6), 1283–91.CrossRefGoogle ScholarPubMed
Campbell, M., Fish, B., David, R., Shapiro, T., Collins, P. & Koh, C. (1972). Response to triiodothyronine and dextroamphetamine: a study of preschool schizophrenic children. Journal of Autism and Childhood Schizophrenia, 2, 343–58.CrossRefGoogle ScholarPubMed
Campbell, M., Fish, B., Korein, J.et al. (1972). Lithium and chlorpromazine: A controlled crossover study of hyperactive severely disturbed young children. Journal of Autism and Childhood Schizophrenia, 2, 234–63.CrossRefGoogle ScholarPubMed
Campbell, M., Small, A. M., Collins, P. J., Friedman, E., David, R. & Genieser, N. (1976). Levodopa and levoamphetamine: A crossover study in young schizophrenic children. Current Therapeutic Research, 19, 70–86.Google ScholarPubMed
Carlsson, M. L. (1998). Hypothesis: is infantile autism a hypoglutamatergic disorder? Relevance of glutamate – serotonin interactions for pharmacotherapy. Journal of Neural Transmission, 105, 525–35.CrossRefGoogle ScholarPubMed
Chez, M. G., Aimonovitch, M., Buchanan, T., Mrazek, S. & Tremb, R. J. (2004). Treating autistic spectrum disorders in children: utility of the cholinesterase inhibitor rivastigmine tartrate. Journal of Child Neurology, 19, 165–9.Google ScholarPubMed
Chez, M. G., Buchanan, C. P., Bagan, B. T.et al. (2000). Secretin and autism: A two-part clinical investigation. Journal of Autism and Developmental Disorders, 30, 87–94.CrossRefGoogle ScholarPubMed
Cohen, S. A., Fitzgerald, B. J., Khan, S. R. & Khan, A. (2004). The effect of a switch to ziprasidone in an adult population with autistic disorder: chart review of naturalistic, open-label treatment. Journal of Clinical Psychiatry, 65(1), 110–13.CrossRefGoogle Scholar
Coniglio, S. J., Lewis, J. D., Lang, C.et al. (2001). A randomized, double-blind, placebo-controlled trial of single-dose intravenous secretin as treatment for children with autism. Journal of Pediatrics, 138, 649–55.CrossRefGoogle ScholarPubMed
Dunn-Geier, J., Ho, H. H., Auersperg, E.et al. (2000). Effect of secretin on children with autism: a randomized controlled trial. Developmental Medicine and Child Neurology, 42, 796–802.CrossRefGoogle ScholarPubMed
Ernst, M., Magee, H. J., Gonzalez, N. M.et al. (1992). Pimozide in autistic children. Psychopharmacology Bulletin, 28, 187–91.Google ScholarPubMed
Fankhauser, M. P., Karumanchi, V. C., German, M. L., Yates, A. & Karumanchi, S. D. (1992). A double-blind, placebo-controlled study of the efficacy of transdermal clonidine in autism. Journal of Clinical Psychiatry, 53, 77–82.Google ScholarPubMed
Farmer, J., Donders, J. & Warschausky, S. (2006). Treating neurodevelopmental disabilities: Clinical research and practice. New York: Guilford Press.Google Scholar
Feldman, H. M., Kolmen, B. K. & Gonzaga, A. M. (1999). Naltrexone and communication skills in young children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 587–93.CrossRefGoogle ScholarPubMed
Findling, R. L. (2005). Pharmacological treatment of behavioral symptoms in autism and pervasive developmental disorders. Journal of Clinical Psychiatry, 66, Suppl 10: 26–31.Google ScholarPubMed
Fish, B., Shapiro, T. & Campbell, M. (1966). Long-term prognosis and the response of schizophrenic children to drug therapy: A controlled study of trifluoperazine. American Journal of Psychiatry, 123, 32–9.CrossRefGoogle ScholarPubMed
Gagliano, A., Germano, E., Pustorino, G.et al. (2004). Risperidone treatment of children with autistic disorder: effectiveness, tolerability, and pharmacokinetic implications. Journal of Child and Adolescent Psychopharmacology, 14, 39–47.CrossRefGoogle ScholarPubMed
Geller, E., Ritvo, E. R., Freeman, B. J. & Yuwiler, A. (1982). Preliminary observations on the effect of fenfluramine on blood serotonin and symptoms in three autistic boys. New England Journal of Medicine, 307, 165–9.CrossRefGoogle ScholarPubMed
Gillberg, C. (1995). Endogenous opiods and opiate antagonists in autism: brief review of empirical findings and implications for clinicians. Developmental Medicine and Child Neurology, 37, 239–45.CrossRefGoogle Scholar
Hagerman, R. J. (1999). Neurodevelopmental disorders: Diagnosis and treatment. New York: Oxford University Press.Google Scholar
Handen, B. L., Johnson, C. R. & Lubetsky, M. (2000). Efficacy of methylphenidate among children with autism and symptoms of attention-deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 30, 245–55.CrossRefGoogle ScholarPubMed
Hardan, A. Y. & Handen, B. L. (2002). A retrospective open trial of adjunctive donepezil in children and adolescents with autistic disorder. Journal of Child and Adolescent Psychopharmacology, 12, 237–41.CrossRefGoogle ScholarPubMed
Hellings, J., Weckbaugh, M., Nickel, E., Cain, S., Zarcone, J., Reese, R.et al. (2005). A double-blind, placebo-controlled Study of Valproate for aggression in youth with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15, 682–92.CrossRefGoogle ScholarPubMed
Hollander, E., Dolgoff-Kaspar, R., Cartwright, C., Rawitt, R. & Novotny, S. (2001). An open trial of divalproex sodium in autism spectrum disorders. Journal of Clinical Psychiatry, 62(7), 530–4.CrossRefGoogle ScholarPubMed
Horvath, K., Stefanatos, G., Sokolski, K. N.et al. (1998). Improved social and language skills after secretin administration in patients with autistic spectrum disorders. Journal of the Association for Academic Minority Physicians, 9, 9–15.Google ScholarPubMed
Jaselskis, C. A., Cook, E. H., Fletcher, K. E. & Leventhal, B. L. (1992). Clonidine treatment of hyperactive and impulsive children with autistic disorder. Journal of Clinical Psychopharmacology, 12, 322–7.CrossRefGoogle ScholarPubMed
Kemner, C., Willemsen-Swinkels, S. H., Jonge, M., Tuynman-Qua, H. & Engeland, H. (2002). Open-label study of olanzapine in children with pervasive developmental disorder. Journal of Clinical Psychopharmacology, 22, 455–60.CrossRefGoogle ScholarPubMed
King, B., Wright, D., Handen, B.et al. (2001). A double-blind, placebo-controlled study of amantidine hydrochloride in the treatment of children with autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 658–65.CrossRefGoogle ScholarPubMed
Kleijnen, J. & Knipschild, P. (1991). Niacin and vitamin B6 in mental functioning: a review of controlled trials in humans. Biological Psychiatry, 29, 931–41.CrossRefGoogle ScholarPubMed
Klin, A. & Volkmar, F. R. (2000). Treatment and intervention guidelines for individuals with Asperger syndrome. In Klin, A., Volkmar, F. R. & Sparrow, S., eds., Asperger syndrome. New York: Guilford Press, pp. 340–65.Google ScholarPubMed
Klin, A., Volkmar, F., Schultz, R., Pauls, D. & Cohen, D. J. (1997). Asperger's syndrome: phenomenology, neuropsychology, and neurobiology. Presented at the 44th Annual Meeting of the American Academy of Child and Adolescent Psychiatry, Toronto, Oct. 16.
Klin, A., Volkmar, F. R. & Sparrow, S. (2000). Asperger syndrome. New York: Guilford Press.Google ScholarPubMed
Leventhal, B. L., Cook, E. H. Jr., Morford, M.et al. (1993). Clinical and neurochemical effects of fenfluramine in children with autism. Journal of Neuropsychiatry and Clinical Neuroscience, 5(3), 307–15.Google ScholarPubMed
Malone, R. P., Cater, J., Sheikh, R. M., Choudhury, M. S. & Delaney, M. A. (2001). Olanzapine versus haloperidol in children with autistic disorder: an open pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 887–94.CrossRefGoogle Scholar
Martin, A., Scahill, L., Klin, A. & Volkmar, F. R. (1999). Higher-functioning pervasive developmental disorders: rates and patterns of psychotropic drug use. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 923–31.CrossRefGoogle ScholarPubMed
Martineau, J., Barthelemy, C., Cheliakine, C. & LeLord, G. (1988). Brief report: an open middle-term study of combined vitamin B6-magnesium in a subgroup of autistic children selected on their sensitivity to this treatment. Journal of Autism and Developmental Disorders, 18, 435–47.CrossRefGoogle Scholar
Masi, G., Cosenza, A., Mucci, M. & Brovedani, P. (2001). Open trial of risperidone in 24 young children with pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1206–14.CrossRefGoogle ScholarPubMed
Masi, G., Cosenza, A., Mucci, M. & Brovedani, P. (2003). A 3-year naturalistic study of 53 preschool children with pervasive developmental disorders treated with risperidone. Journal of Clinical Psychiatry, 64, 1039–47.CrossRefGoogle ScholarPubMed
Mautner, V. F., Kluwe, L., Thakker, S. D. & Leark, R. A. (2002). Treatment of ADHD in neurofibromatosis type 1. Developmental Medicine and Child Neurology, 44, 164–70.CrossRefGoogle ScholarPubMed
McCracken, J. T., McGough, J., Shah, B.et al. (2002). Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine, 347, 314–21.CrossRefGoogle ScholarPubMed
McDougle, C. J., Holmes, J. P., Bronson, M. R.et al. (1997). Risperidone treatment of children and adolescents with pervasive developmental disorders: a prospective open-label study. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 685–93.CrossRefGoogle ScholarPubMed
McDougle, C. J., Holmes, J. P., Carlson, D. C.et al. (1998). A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Archives of General Psychiatry, 55, 633–41.CrossRefGoogle ScholarPubMed
Molloy, C. A., Manning-Courtney, P., Swayne, S.et al. (2002). Lack of benefit of intravenous synthetic human secretin in the treatment of autism. Journal of Autism and Developmental Disorders, 32, 545–51.CrossRefGoogle ScholarPubMed
MTA Cooperative Group. (2004). National Institutes of Mental Health Multimodal Treatment Study of ADHD followup: 24-month outcomes of treatment strategies for attention deficit/hyperactivity disorder. Pediatrics, 113, 754–61.CrossRef
Naruse, H., Nagahata, M., Nakane, Y.et al. (1982). A multi-center double-blind trial of pimozide (Orap), haloperidol and placebo in children with behavioral disorders, using crossover design. Acta Paedopsychiatrica, 48, 173–84.Google Scholar
Niederhofer, H., Staffen, W. & Mair, A. (2002). Lofexidine in hyperactive and impulsive children with autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1396–7.CrossRefGoogle ScholarPubMed
Owley, T. (2002) The pharmacological treatment of Autistic Spectrum Disorders. CNS Spectrums, 7, 663–9.CrossRefGoogle ScholarPubMed
Owley, T., Leventhal B. L. & Cook E. H., Jr. (2006). The Autism Spectrum Disorders. In Klykylo, W. M., Kay, J., Rube, D., eds., Clinical child psychiatry, 2nd edn. (Indianapolis, In: John Wiley and Sons.) pp. 371–89.Google Scholar
Owley, T. (2004). Emergency room treatment of children and adolescents with autistic spectrum disorders. Clinical Pediatric Emergency Medicine, 5, 187–92.CrossRefGoogle Scholar
Owley, T., McMahon, W., Cook, E. H.et al. (2001). Multi-site, double-blind, placebo-controlled trial of porcine secretin in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1293–9.CrossRefGoogle Scholar
Owley, T., Salt, J., Guter, S.et al. (2006). A prospective, open-label trial of memantine in the treatment of cognitive, behavioral, and memory dysfunction in pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 16, 517–524.CrossRefGoogle ScholarPubMed
Owley, T., Walton, L., Salt, J.et al. (2005). An open-label trial of escitalopram in pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 343–8.CrossRefGoogle ScholarPubMed
Percy, A. K., Glaze, D. G., Schultz, R. J.et al. (1994). Rett syndrome: controlled study of an oral opiate antagonist, naltrexone. Annals of Neurology, 35, 464–70.CrossRefGoogle ScholarPubMed
Pfeiffer, S. I., Norton, J., Nelson, L. & Shott, S. (1995). Efficacy of vitamin B6 and magnesium in the treatment of autism: a methodology review and summary of outcomes. Journal of Autism and Developmental Disorders, 25, 481–93.CrossRefGoogle ScholarPubMed
Plioplys, A. (1994). Autism: Electroencephalographic abnormalities and clinical improvement with valproic acid. Archives of Pediatrics & Adolescent Medicine, 148, 220–2.CrossRefGoogle Scholar
Potenza, M. N., Holmes, J. P., Kanes, S. J. & McDougle, C. J. (1999). Olanzapine treatment of children, adolescents, and adults with pervasive developmental disorders: an open-label pilot study. Journal of Clinical Psychopharmacology, 19, 37–44.CrossRefGoogle ScholarPubMed
Quintana, H., Birmaher, B., Stedge, D.et al. (1995). Use of methylphenidate in the treatment of children with autistic disorder. Journal of Autism and Developmental Disorders, 25, 283–94.CrossRefGoogle ScholarPubMed
Ratey, J., Bemporad, J., Sorgi, P.et al. (1987). Brief Report: Open trial effects of beta-blockers on speech and social behaviors in 8 autistic adults. Journal of Autism and Developmental Disorders, 17, 439–46.CrossRefGoogle Scholar
Realmuto, G. M., August, G. J. & Garfinkel, B. (1989). Clinical effect of buspirone in autistic children. Journal of Clinical Psychopharmacology, 9, 122–5.CrossRefGoogle ScholarPubMed
Roberts, W., Weaver, L., Brian, J.et al. (2001). Repeated doses of porcine secretin in the treatment of autism: A randomized, placebo-controlled trial. Pediatrics, 107, E71.CrossRefGoogle ScholarPubMed
Rugino, T. A. & Samsock, T. C. (2002). Levetiracetam in autistic children: an open-label study. Journal of Developmental and Behavioral Pediatrics, 23, 225–30.CrossRefGoogle Scholar
RUPP(Research Units on Pediatric Psychopharmacology Group). (2005). Randomized, controlled, crossover Trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry, 62, 1266–74.CrossRef
Sandler, A. D., Sutton, K. A. & DeWeese, J. (1999). Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive developmental disorder. New England Journal of Medicine, 341, 1801–6.CrossRefGoogle ScholarPubMed
Schmidt, K. (1982). The effect of stimulant medication in childhood-onset pervasive developmental disorder – a case report. Journal of Developmental and Behavioral Pediatrics, 3, 244–6.CrossRefGoogle ScholarPubMed
Schuster, C. R., Lewis, M. & Seiden, L. S. (1986). Fenfluramine: Neurotoxicity. Psychopharmacology Bulletin, 22, 148–51.Google ScholarPubMed
Sporn, A. & Pinsker, H. (1981). Use of stimulant medication in treating pervasive developmental disorder. American Journal of Psychiatry, 138, 997.Google ScholarPubMed
Stigler, K. A., Desmond, L. A., Posey, D. J., Wiegand, R. E. & McDougle, C. J. (2004). A naturalistic retrospective analysis of psychostimulants in pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 14, 49–56.CrossRefGoogle ScholarPubMed
Strayhorn, J. M. Jr., Rapp, N., Donina, W. & Strain, P. S. (1988). Randomized trial of methylphenidate for an autistic child. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 244–7.CrossRefGoogle ScholarPubMed
Symons, F. J., Thompson, A. & Rodriguez, M. C. (2004). Self-injurious behavior and the efficacy of naltrexone treatment: A quantitative synthesis. Mental Retardation and Developmental Disabilities Research Review, 10, 193–200.CrossRefGoogle ScholarPubMed
Unis, A. S., Munson, J. A., Rogers, S. J.et al. (2002). A randomized, double-blind, placebo-controlled trial of porcine versus synthetic secretin for reducing symptoms of autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1315–21.CrossRefGoogle ScholarPubMed
Vining, E. P. G., Mellits, D., Dorsen, M. M.et al. (1987). Psychologic and behavioral effects of antiepileptic drugs in children: A double-blind comparison between phenobarbital and valproic acid. Pediatrics, 80, 165–74.Google ScholarPubMed
Vitriol, C. & Farber, B. (1981). Stimulant medication in certain childhood disorders. American Journal of Psychiatry, 138, 1517–18.Google ScholarPubMed
Volkmar, F. R. & Nelson, D. S. (1990). Seizure disorders in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 127–9.CrossRefGoogle ScholarPubMed
Volkmar, F. R., Stier, D. M. & Cohen, D. J. (1985). Age of recognition of pervasive developmental disorder. American Journal of Psychiatry, 142, 1450–2.Google ScholarPubMed
Willemsen-Swinkels, S. H. N., Buitelaar, J. K., Nijhof, G. J. & Engeland, H. (1995). Failure of naltrexone hydrochloride to reduce self-injurious and autistic behavior in mentally retarded adults – Double-blind placebo-controlled studies. Archives of General Psychiatry, 52, 766–73.CrossRefGoogle ScholarPubMed
Williams, D. T., Mehl, R., Yudofsky, S., Adams, D. & Roseman, B. (1982). The effect of propranolol on uncontrolled rage outbursts in children and adolescents with organic brain dysfunction. Journal of the American Academy of Child and Adolescent Psychiatry, 21, 129–35.CrossRefGoogle ScholarPubMed
Wilmut, I., Schnieke, A. E., McWhir, J., Kind, A. J. & Campbell, K. H. S. (1997). Viable offspring derived from fetal and adult mammalian cells. Nature, 385(6619), 810–13.CrossRefGoogle ScholarPubMed
Yuwiler, A., Brammer, G. L., Morley, J. E.et al. (1981). Short-term and repetitive administration of oral tryptophan in normal men – effects on blood tryptophan, serotonin, and kynurenine concentrations. Archives of General Psychiatry, 38, 619–26.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×