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Conversion of serotonin to N -acetylserotonin by serotonin N -acetyltransferase may be upregulated in the same set of FENNS patients, possibly related to the observed alteration in TRP5-HIAA correlation ( Secondly, we have shown that a neurotoxic product of TRP metabolism, 3-OHKY, predicts severity of clinical symptoms during the early phase of illness and before exposure to antipsychotic drugs ( Lastly, optimum levels of purine metabolites have been associated with the dynamics of clinical symptoms and therapeutic improvements, which may lead to discovery of novel targets for drug development