The association between risk factors for tardive dyskinesia and phenylalanine-induced abnormal movements in schizophrenia

Authors

  • S. K. Schultz,

    Corresponding author
    1. Mental Health Clinical Research Center, University of Iowa, Iowa City, IA, USA
    2. University of Iowa Department of Psychiatry, Iowa City, IA, USA
    • Psychiatry Research, 1-189A MEB, University of Iowa College of Medicine, Iowa City, IA 52242-1000, USA.
    Search for more papers by this author
  • V. Ellingrod,

    1. Mental Health Clinical Research Center, University of Iowa, Iowa City, IA, USA
    2. University of Iowa Department of Pharmacy, Iowa City, IA, USA
    Search for more papers by this author
  • F. W. Fleming,

    1. Mental Health Clinical Research Center, University of Iowa, Iowa City, IA, USA
    Search for more papers by this author
  • N. C. Andreasen

    1. Mental Health Clinical Research Center, University of Iowa, Iowa City, IA, USA
    2. University of Iowa Department of Psychiatry, Iowa City, IA, USA
    Search for more papers by this author

Abstract

We examined whether an oral challenge dose of the amino acid phenylalanine (a dopamine precursor) exacerbates the abnormal movements of tardive dyskinesia (TD). We also examined age, gender, treatment duration, and baseline movement severity in relation to phenylalanine-induced changes in movements. Lastly, we assessed the influence of fasting amino acid levels on phenylalanine-induced movements. In a placebo-controlled fashion, the abnormal involuntary movement scale (AIMS) was obtained on 25 patients before and after a phenylalanine challenge drink. A general linear model determined the relative effects of age, gender, treatment duration, and fasting amino acid levels on the magnitude of induced movements. Age and treatment duration did not affect phenylalanine-induced movements. Lower fasting levels of phenylalanine were associated with greater movements after controlling for age, F = 11.89, p < 0.003. The severity of abnormal movements at baseline also predicted response to phenylalanine, F = 8.62, p = 0.0079. Brain amino acid and neurotransmitter pools are influenced by changes in dietary protein, which may have implications in the development and prevention of movement disorders. This study suggests that fasting amino acid levels may predict differences in vulnerability to movements during an influx of neurotransmitter precursors, perhaps due to long-term compensatory changes in receptor sensitivity. Copyright © 2001 John Wiley & Sons, Ltd.

Ancillary