[Search for users] [Overall Top Noters] [List of all Conferences] [Download this site]

Conference hydra::dejavu

Title:Psychic Phenomena
Notice:Please read note 1.0-1.* before writing
Moderator:JARETH::PAINTER
Created:Wed Jan 22 1986
Last Modified:Tue May 27 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:2143
Total number of notes:41773

1209.0. "Sleep Walking" by SUBURB::MARSHC () Tue Feb 06 1990 06:17

    Can anybody Help ??  I have looked through and can't find anything
    on sleepwalking...a friend of mine has problems waking up in other
    parts of her house...sometimes outside....it frightens her considerably
    although she can never remember how she got there or what she was
    dreaming..if anything..  Any advise ?
    
    Thanks
    
    Chrissie
    
T.RTitleUserPersonal
Name
DateLines
1209.1In other words, I don't know much about itBRNIN::BESTH.V. AttenuatorTue Feb 06 1990 10:497
    
    There is actually a drug that will at least lower the frequency
    of sleepwalking, but I'm not sure if it is still experimental or
    if it's on the market.  And it may not work for everyone.  Maybe
    a doctor would know, or Topher.........:-)
    
    guy
1209.2VITAL::KEEFEBill Keefe - 223-1837 - MLO1-2Tue Feb 06 1990 13:145
    There are places that handle sleep disorders. Finding one of these
    clinics or hospitals could be a good first step. Perhaps some other
    reader could either recommend one or give a pointer to one.
    
    	- Bill
1209.3She should see a Dr., but not worry.CADSYS::COOPERTopher CooperTue Feb 06 1990 16:5616
    Sleepwalking is similar to night terrors, of which there are a number
    of notes, and night paralysis, of which is also mentioned elsewhere in
    this conference.
    
    Like those problems, it is generally harmless, if scary.  Once in a
    great while it is an indication of some more serious problem, so
    a doctor *should definitely be consulted*.  They might recommend a
    neurologist or a sleep pathology clinic.  Generally, however,
    sleepwalking is just something that some people do occasionally. 
    Incidents of it are frequently triggered in people with the tendency by
    stress.
    
    Once again, your friend should *definitely* talk to a doctor to be on
    the safe side, but their isn't likely to be anything to worry about.
    
    							Topher
1209.4AKOV06::HPCSTue Feb 06 1990 18:3016
    I've done many wild things while sleep walking since I was a kid.
    My parents have heard me unlock the door and leave the house, 
    they've found me standing on my bed, etc.
    The worst was when I jumped out of a 2.5 story window. (true story,
    I'll give details if anyone's interested.)
    
    Many other weird happenings as I've grown older.
    
     What I've found keeps me in one place (in addition to help from my
     wife) are the following things:
    
      1) Read or do something relaxing before bed.
      2) Don't go to bed too early. Be sure you are tired.
      3) Try to do some type of physical activity during the day
    
    
1209.5SleepCGVAX2::PAINTERAnd on Earth, peace...Tue Feb 06 1990 20:5526
    Re.0
    
    Ditto on the sleep clinic recommendation by Bill Keefe.  
    
    You might also check the MEDICAL conference to see if there are any 
    references over there to this problem.  It's traditional medicine-
    oriented, in case you and your friend lean toward a more holisitic 
    approach, fyi.
    
    On a related topic:
    
    TRYPTOPHAN PROBLEM???
    
    I went into my trusty drug store the other day to pick up some
    tryptophan (an amino acid which helps people get to sleep), and it had 
    been pulled from the shelves with a note in its place reading: 
    
    	"WARNING - there have been several serious illnesses and
    	 even death related to tryptophan.  Please return all unused 
       	 portions to the store."
    
    Unfortunately the fellow at the counter had no other specifics. 
    Anybody else heard this?   I've been taking tryptophan for over 5 
    years without any problem.
    
    Cindy
1209.6He was so funny!BSS::SU_DONAHUESpur of the momentTue Feb 06 1990 21:1111
    My brother used to sleep walk when he was little.  The family jokes
    about the time he fed the dog a whole box of Oreos and painted the
    fireplace bricks with peanut butter.  My mother almost killed him ...
    
    He grew out of it.  My parents found that if he ate heavily before he 
    went to sleep, he was more prone to sleep walking.  If he ate something
    light an hour or so before, he would usually sleep through the night.
    
    I would definitely see a doctor, though.
    
    Susan
1209.7Thanks For All Your HelpSUBURB::MARSHCWed Feb 07 1990 06:3710
    Thanks everyone, she's going to take the advise of relaxing more
    and see how that goes,  if she still goes walk abouts I think maybe
    ahe should go and see a doctor..though she doesn't want to start
    taking drugs if she can help it...frankly I think hypnotherapy (I
    don't know how to spell it)  is probaly better...it worked on Neibours
    for Madge anyway..
    
    Thanks again
    
    Chrissie
1209.8I've heardBLIVIT::KALLISPumpkins -- Nature's greatest gift.Wed Feb 07 1990 11:4331
    Re .5 (Cindy):
    
    >On a related topic:
    >
    >TRYPTOPHAN PROBLEM???
    >
    >I went into my trusty drug store the other day to pick up some
    >tryptophan (an amino acid which helps people get to sleep), and it had 
    >been pulled from the shelves with a note in its place reading: 
    >
    >	"WARNING - there have been several serious illnesses and
    >	 even death related to tryptophan.  Please return all unused 
    >  	 portions to the store."
    >
    >Unfortunately the fellow at the counter had no other specifics. 
    >Anybody else heard this?   I've been taking tryptophan for over 5 
    >years without any problem.
     
    Yes, I've heard of it.  L-Tryptophan is something my wife's been
    taking for years, without ill effect.  However, according to the
    reports I heard, some of the manufacturers have been a bit careless
    in the processing, and some batches of L-Tryptophan tablets apparently
    became contaminated with bacteria or some-such that might bring
    on various blood disorders/diseases.  Although the percentage is
    small, my wife immediately threw out the remaining tablets.
    
    To help get to sleep, as good substitute for L-tryptophan is pure
    Vitamin B-1 (that is, not in B-complex or multivitamin) pills.
    A couple of hundred milligrams wioll do wonders.
    
    Steve Kallis, Jr.
1209.9Tryptophan ToxicityCARTUN::BERGGRENBelieving is seeing...Wed Feb 07 1990 14:439
    Cindy re: Tryptophan,
    
    I also saw a report recently about the dangers of tryptophan
    which said it has recently been discovered, for some individuals, 
    that a toxicity level can be reached by taking too much tryptophan, 
    causing a condition which the medical community now refers to as 
    tryptophan poisoning....which can result in paralysis and death.
    
    Karen
1209.10Drugs & MedicationSUBURB::MARSHCThu Feb 08 1990 06:1212
    Surely taking any kind of drug for something as natural as sleep
    can't be good for you no matter what it is...even taking to many
    vitamins can cause you damage (they say).  I remember when I was
    a kid asking my mum if there was anything I could take to help me
    sleep due to the fact I was having horrific nightmares...she was
    livid that I could even think of such a idea and explianed to me
    that if I started taking such 'medication' I would probaly end up
    relying on them to get sleep at all.  
    
    Chrissie
    
    
1209.11Abuse does not destroy use.ATSE::WAJENBERGI Ching, You Ching, It ChingsThu Feb 08 1990 11:5815
    Re .10
    
    "Surely taking any kind of drug for something as natural as sleep can't
    be good for you..."
    
    Walking around in your sleep might not be good for you, either.  It's a
    cinch that feeding large quantities of cookies to the dog (as someone
    did in their sleep in an earlier note) isn't good for the dog...
    
    How did your mum feel about a glass of warm milk before bed?  Or a cup
    of coffee to get started in the morning?  The warm milk and the coffee
    are both chemicals that alter the operation of the nervous system, just
    the way a chemical labeled "drug" does.
    
    Earl Wajenberg
1209.12ReplyCGVAX2::PAINTERAnd on Earth, peace...Fri Feb 09 1990 20:3731
    
    Re. Tryptophan
    
    Thanks, Steve and Karen.  I'll get rid of mine as well.  B1 does sound
    familiar as a sleep aid - will take a look at my books again as it's
    been a while.
    
    Re.10 (Marsh)
    
    Hi Chrissie - tryptophan (or l-tryptophan) is not a drug, it is an
    amino acid which is non-addictive, and occurs naturally in foods such
    as turkey (some speculate that this is also behind the reason why
    everybody naps after a Thanksgiving dinner (;^).  It is to be found in
    the vitamins and minerals section of your local pharmacy.  I've read
    several studies on it over the last 5 years and until the recent
    problem, it has been one of those things deemed safe to take up to a 
    dose as large as 6 grams (though I've only ever taken a maximum of 2 
    grams in one night).
    
    On the other hand though, there are vitamins, particularly B6, which
    were at one time considered safe in any amount (the water-soluble
    family), have now been shown to cause nerve damage (60 Minutes did a 
    piece on this, in addition to the health-related publications).  The 
    maximum amount of B6 now recommended by the studies is no more than 
    50mg. per night unless you are under doctor's supervision.
    
    So, as you say, it's always best to be careful to what you put into 
    your body in any case, and I'm with you on not taking medication to 
    correct a problem if a non-medicative solution can be found. 
          
    Cindy
1209.13Benign, perhaps, but certainly a drug.CADSYS::COOPERTopher CooperTue Feb 13 1990 14:1048
RE: .12 (Cindy)
    
    Cindy, I am by no means anti-tryptophan, but it is most certainly a
    drug.  To me that word is not a scare word, and I believe that the
    whole "just say no" campaign is a serious mistake based on very muddled
    thinking.  Drug in no way implies "bad", nor does drug "use" imply
    drug abuse.
    
    The only reasonable definition of a drug (and even this has some real
    fuzziness in places) is that a drug is anything which by "ingestion"
    (defined broadly to include inhalation, injection, etc.) causes a
    change in body (including brain) function.
    
    Tryptophan certainly fits that definition.  Generally in food,
    tryptophan occurs in rather small quantities and balanced with other
    amino acids (i.e., as part of proteins).  The body has mechanisms
    for dealing with it "normally" under those circumstances.  By taking
    it in large, unbalanced quantities the body is unable to handle it
    in the normal way and we get the alternate metabolism which promotes
    sleepiness.
    
    I don't say that that is a bad thing -- drugs give our
    intellect a control of our body which nature has not had time to
    evolve directly (nature underutilizes our intellect, people tend to
    misutilize it).  I use the drug caffein on a regular (and I think
    properly moderate) basis to regulate my body/brain's level of
    alertness, I see nothing wrong with using tryptophan in a complementary
    fasion.
    
    That tryptophan occurs in food (specifically that it occurs in some
    food in enough excess to perhaps trigger the sleepiness response) does
    not argue that it is not a drug: opium occurs naturally in lettuce,
    and fruit contains both sugar (which in concentration is most certainly
    a drug) and alcohol.
    
    The association of "addiction" with physical dependence (i.e., physical
    withdrawal symptoms) has been abandoned -- it was never a very sensible
    idea, it being based on the rationalization of adicts that the physical
    withdrawal was the reason they were unable to quit.  Last I heard, no
    physical dependence had yet been found for cocaine, including, crack
    cocaine one of the most visciously addicting substances known.  Any
    drug producing results which are percieved as desirable by the ingester
    can be addicting (the only exception I know are self-limiting drugs
    such as Ecstacy which "stops working" at any dosage after a relatively
    small number of doses; this may, however, be due to permanant brain
    damage, so that doesn't make it automatically a desirable property).
    
    						Topher
1209.14ReplyCGVAX2::PAINTERAnd on Earth, peace...Tue Feb 13 1990 16:05105
Re.13 (Cooper)

Hi Topher,

>   The only reasonable definition of a drug (and even this has some real
>   fuzziness in places) is that a drug is anything which by "ingestion"
>   (defined broadly to include inhalation, injection, etc.) causes a
>   change in body (including brain) function.

    Then it would seem that anything at all we inject, ingest or inhale 
    could be potentially labeled as a drug according to this definition.

    I was using the definition #2 from my American Heritage Dictionary which 
    is as follows:

	drug n. 1. A substance used as medicine in the treatment of a disease.
                2. A narcotic (defined as - A drug that dulls the senses,      
                               induces sleep, and becomes addictive with
                               prolonged use)  [This is the part of the 
                               definition which I believe you are refuting
                               later in this note?]

    
>   I am by no means anti-tryptophan, but it is most certainly a drug.  

    In the way you've defined it, and also according to definition #1 
    above, I concur.


>   To me that word is not a scare word, and I believe that the
>   whole "just say no" campaign is a serious mistake based on very muddled
>   thinking.  

    I strongly disagree.  See below.


>   Drug in no way implies "bad", nor does drug "use" imply drug abuse.

    If you see the campaign as doing this, then I understand your comment
    about muddled thinking.  I still disagree though, since I don't see the
    campaign as doing this (they're not out there preaching against aspirin,
    for example).  But this is probably another discussion altogether.
    
    
>   Tryptophan certainly fits that definition.  Generally in food,
>   tryptophan occurs in rather small quantities and balanced with other
>   amino acids (i.e., as part of proteins).  The body has mechanisms
>   for dealing with it "normally" under those circumstances.  By taking
>   it in large, unbalanced quantities the body is unable to handle it
>   in the normal way and we get the alternate metabolism which promotes
>   sleepiness.

    (Still classifying tryptophan as a drug...) - this would seem to be 
    different than a drug classified as a narcotic, yes/no?  A narcotic,
    to me, is a drug which is one must use in increasing amounts in order 
    to produce the same state as experienced in the previous use.   I don't
    believe tryptophan works in this way, based on the readings and direct
    experience I've had with it.

    
>   I don't say that that is a bad thing -- drugs give our intellect a 
>   control of our body which nature has not had time to evolve directly 
>   (nature underutilizes our intellect, people tend to misutilize it).  

    I don't say it's a bad thing either.  I was assuming that the person who
    made the inquiry earlier on was using the narcotic definition and I wrote
    a response addressing that assumption.


>    I use the drug caffein on a regular (and I think
>    properly moderate) basis to regulate my body/brain's level of
>    alertness, I see nothing wrong with using tryptophan in a complementary
>    fasion.

Nor do I.

    
>    That tryptophan occurs in food (specifically that it occurs in some
>    food in enough excess to perhaps trigger the sleepiness response) does
>    not argue that it is not a drug: opium occurs naturally in lettuce,
>    and fruit contains both sugar (which in concentration is most certainly
>    a drug) and alcohol.

     I wasn't arguing that it wasn't a drug.  I believe we were using 
     different definitions.

 
>    The association of "addiction" with physical dependence (i.e., physical
>    withdrawal symptoms) has been abandoned -- it was never a very sensible
>    idea, it being based on the rationalization of adicts that the physical
>    withdrawal was the reason they were unable to quit.  Last I heard, no
>    physical dependence had yet been found for cocaine, including, crack
>    cocaine one of the most visciously addicting substances known.  Any
>    drug producing results which are percieved as desirable by the ingester
>    can be addicting (the only exception I know are self-limiting drugs
>    such as Ecstacy which "stops working" at any dosage after a relatively
>    small number of doses; this may, however, be due to permanant brain
>    damage, so that doesn't make it automatically a desirable property).

    It's interesting as I'm having this discussion with someone else.  I agree
    with the physical dependence part you wrote of above, yet at the same time,
    my outstanding question on this is "What about crack babies (those born 
    'addicted' to crack, and how do they fit into this scenario?

Cindy
1209.15GVAADG::DONALDSONthe green frog leaps...Wed Feb 14 1990 10:1132
    Re: .14, Cindy

>    I was using the definition #2 from my American Heritage Dictionary which 
>    is as follows:
>
>	drug n. 1. A substance used as medicine in the treatment of a disease.
>                2. A narcotic (defined as - A drug that dulls the senses,      
>                               induces sleep, and becomes addictive with
>                               prolonged use)  [This is the part of the 
>                               definition which I believe you are refuting
>                               later in this note?]

    Using this definition of 'drug' what would you call LSD?
    Or am I getting confused by '#2' and '2.'?

    And here you are, have a few of my opinions... :-)

    I find most of the posturing by governments about 'drugs'
    to be ridiculous and illogical. Including the latest
    hi-tech, high-profile attempts at controlling cocaine.
    (Remember prohibition?). Like abortion or euthanasia there
    are lots of votes in drugs - or am I being cynical.

    Legalising , taxing and controlling recreational drugs
    would solve most problems.

    I'd like to propose that a distinction - a good drug
    increases your well-being and freedom and not at the
    expense of another person's - a bad drug decreases
    your well-being and freedom.

John.
1209.16and lets have no rude replys about licking frogsGVAADG::DONALDSONthe green frog leaps...Wed Feb 14 1990 10:120
1209.17Oh C'mon John, why not?VTFARM::BESTH.V. AttenuatorWed Feb 14 1990 11:461
    
1209.18Slurp!!!! Er, I mean, Croak!CGVAX2::PAINTERAnd on Earth, peace...Wed Feb 14 1990 21:061
    
1209.19More on tryptophanCGVAX2::PAINTERAnd on Earth, peace...Wed Feb 14 1990 21:1111
    
    
    
    John D. - I know very little about LSD and can't comment on it.  
    
    As for the tryptophan warning, received the most recent copy of
    "Nutrition Action Healthletter" yesterday and it had an article on it. 
    Of course I promptly left it home today..(;^(, so will remember to
    bring it in soon and enter it here.  
    
    Cindy
1209.20GVAADG::DONALDSONthe green frog leaps...Thu Feb 15 1990 11:559
    Re: .19 Cindy,

    don't worry, I'm not being antagonistic. :-)
    It's just that LSD (and many other substances,
    eg. tobacco) are neither 'medicine' or 'narcotic',
    but I don't think most people would have a
    problem about calling them drugs.
    
John.
1209.21Sleep ClinicBUSY::NPEASLEETue Feb 20 1990 15:214
    There is a Sleep Clinic at Beth Israel Hospital in Boston, Ma.
    It has a very good reputation nation-wide.
    
    nmp
1209.22sleep clinicMSESU::CANSLERTue Feb 20 1990 19:308
    
    If you would like you can call me; I go to the sleep clinic at
    Mcleans Hospital for narcolepsy, or send me mail and I will call you.
    I can give you doctors names etc. It is a great clinic.
    
    Bob Cansler
    Milpnd::cansler
    
1209.23Add'l infoCGVAX2::PAINTERAnd on Earth, peace...Tue Feb 20 1990 21:3522
{From: "Nutrition Action Healthletter", January/February 1990, p.3}

Have A Safe Tryptophan
----------------------

Consumers should stop taking L-tryptophan to treat sleep disorders, 
premenstrual syndrome, or chronic pain, say the Food and Drug 
Administration (FDA) and the Centers for Disease Control (CDC).

The FDA and the CDC have identified more than 700 victims of a rare 
blood disorder called eosinophilia.  Almost all had been taking 
L-tryptophan, and amino acid sold over-the-counter.

Eosinophilia usually causes severe muscle pain, and sufferers 
sometimes experience weakness, joint pain, swelling of the arms and 
legs, fever and skin rash.  Doctors aren't sure how to treat the 
illness, though steroids may help.

The FDA says it doesn't yet know whether a contaminant in a "bad" 
batch or the tryptophan itself caused the condition.  Most of the 
victims were not taking high doses.
1209.24One pharmacist's opinionCGVAX2::PAINTERAnd on Earth, peace...Tue Feb 20 1990 21:4926
    Informal chat on tryptophan:                                   
    
    I spoke with my pharmacist friend over the weekend, and he told me of
    what he knew about the tryptophan scare.  He's owned his own pharmacy
    for over 40 years and has been taking vitamin supplements since way 
    before they became popular.  (;^) 
    
    Apparently the people who've contracted the blood disease already had
    a disease (he couldn't remember the name) which, coupled with the 
    tryptophan (or possibly/probably the contaminant), brought on the rare 
    blood disease. 
    
    He believes that the situation has been overblown, and that the
    investigators are now focusing in on which brands of tryptophan the
    people were using at the time to try and come up with some correlation.
    
    He stated also that the largest concentrations of tryptophan are to be
    found in red meat, and if this is the case then people should probably
    stop eating these as well if they are really concerned.  (;^)  
    
    Lastly, he said that tryptophan has been shown to produce some very
    positive conditions in the body, and that it would be unfortunate if it
    were withdrawn indefinitely.
    
    Cindy
    
1209.25Tryptophan update...CIMNET::PIERSONA friend of ERP'sWed Jun 13 1990 18:38112
    Off the UPI News wire, for what its worth...
    
From: clarinews@clarinet.com (HELEN GAUSSOIN)
Newsgroups: clari.tw.health,clari.tw.misc
Subject: Single manufacturer emerges as source of L-tryptophan contamination
Keywords: health, pharmaceutical, health care
Date: 13 Jun 90 01:01:24 GMT
Location: southwest states
Slugword: tryptophan
 
	LOS ALAMOS, N.M. (UPI) -- Evidence increasingly points to a single
    manufacturer as the source of tainted supplies of the health supplement
    L-tryptophan, linked to a debilitating and sometimes fatal ailment,
    doctors said Tuesday.
    
    	But while some researchers say the scientific community is close to
    solving the mystery behind Eosinophilia Myalgia Syndrome, others say
    they are far from a conclusion on the source. All note that they have
    yet to find an effective treatment.
    
    	More than 100 doctors and about a dozen personal injury lawyers
    were in Los Alamos this week to discuss EMS, a condition characterized
    by a high count of eosinophils, a white blood cell, extreme muscle pain
    called myalgia, and fatigue.
    
    	The illness is linked to L-tryptophan, the health supplement widely
    used for insomnia and premenstrual syndrome before it was recalled last
    year.
    
    	The national Centers for Disease Control has confirmed 1,517 cases
    of EMS, 26 of them, fatal. About 2 percent of EMS victims report they
    did not take L-tryptophan, and many thousands of L-tryptophan users
    have not developed EMS.
    
    	But the number of new cases dropped off dramatically after the
    supplement was recalled, and many of those who have developed the
    illness since the recall had continued to take L-tryptophan.
    
    	``We really are on the verge of understanding this epidemic,'' said
    Dr. Gerald Gleich of the Mayo Clinic. ``The data that it's a
    contaminant is overwhelming. It's almost impossible to deny.''
    
    	Gleich said the studies have narrowed down the source to a single
    contaminant in L-tryptophan made by Showa Denko of Japan, and doctors
    are close to identifying the impurity. ``This is simply a matter of
    time,'' he said.
    
    	But Dr. Philip Hertzman, the Los Alamos Medical Center doctor who
    first made the link between the illness and the supplement last fall,
    said the conference has brought out conflicting information and is
    prompting more questions than answers.
    
    	He said some New Mexico patients did not take L-tryptophan made by
    Showa Denko, which has a representative at the conference and is
    offering EMS research grants.
    
    	Dr. Leslie Swygert of the Centers for Disease Control agreed.
    ``It's going to take a very long time (to pinpoint the source of the
    trouble),'' she said. ``We're already finding contaminants ... but we
    need a laboratory model.''
    
    	But Dr. Michael Osterholm of the Minnesota Health Department said
    he believes further investigation will likely show that the New Mexico
    EMS victims who said they did not take L-tryptophan made by Showa Denko
    actually did, but that it was labeled by a different company.
    
    	He said an analysis of the L-tryptophan taken in a single such
    patient in Minnesota showed the same composition as that made by Showa
    Denko, and other studies showed each manufacturer has a distinct
    composition.
    
    	In a summary of reports from New Mexico, New York, Minnesota and
    Oregon, Dr. Ed Maes of the CDC said the evidence suggests that all of
    the cases trace back to L-tryptophan made by Showa Denko between late
    1988 and mid-1989.
    
    	Additional risk factors seem to be age -- most sufferers are in
    their 30s and 40s -- and the amount of L tryptophan taken, Maes said.
    
    	Dr. Ed Belongia of Minnesota said Showa Denko changed its
    manufacturing process in late 1988 and began using a different strain
    of bacteria in the fermentation process and reducing the amount of
    filtering in its process for removing impurities.
    
    	Researchers using chemical analysis and high-performance liquid
    chromatography, a specialized process for separating molecules, found
    an impurity similar to a contaminant linked to the Toxic Oil Syndrome
    that has killed hundreds in Spain. The symptoms of that syndrome and
    EMS are almost identical. The researchers say the impurity also may be
    an antibiotic peptide such as bacitracin, an antibiotic used for skin
    infections.
    
    	Scientists have had less success in finding a treatment for the
    illness and are able only to relieve some symptoms.
    
    	Doctors are finding many patients develop additional symptoms as
    the illness progresses. Dr. Joe Duffy of the Mayo Clinic said the
    illness attacks the skin, bone marrow, heart, muscle tissue, nervous
    system, lungs and abdomen.
    
    	``We've found some very bizarre things along the way,'' said
    Hertzman.
    
    	Dr. Henry Tazelaar, also with the Mayo Clinic, said some patients
    improve dramatically after they stop taking L-tryptophan, some improve
    slowly and some actually get worse.
    
    	The use of cortisteroids has helped some patients but not all and
    some have died while being treated, doctors reported.
    
    	``In some ways, we're gaining on this,'' said Hertzman, ``but, in
    other ways, the story is becoming much more confusing.''