Rapid serotonin depletion as a provocative challenge test for patients with major depression: relevance to antidepressant action and the neurobiology of depression.
Brain serotonin (5-HT) content is dependent on plasma levels of the essential amino acid, tryptophan (TRP). We have previously reported on the effects of rapid dietary TRP depletion in psychiatric patients; this study extends those reports and summarizes the effects of rapid TRP depletion on mood in depressed patients. One hundred and fifteen depressed (according to DSM-III-R) patients (69 drug free and symptomatic; 46 in clinical remission after antidepressant treatment) received tryptophan depletion testing in a double-blind, placebo-controlled, crossover fashion. Of 69 symptomatic, drug-free, depressed patients, 30 percent were unchanged the day of the tryptophan-free drink (TFD), but became clinically less depressed the day after the TFD. Although 80 percent of monoamine oxidase inhibitor- or fluvoxamine-treated patients experienced a depressive relapse during TRP depletion testing, only 18 percent of desipramine-treated patients relapsed. Brain 5-HT function may be intimately involved in the modulation of some affective states and in the mechanism of action of some antidepressant medications.
Delgado
P L
PL
Yale University School of Medicine, Department of Psychiatry, West Haven, CT.
Price
L H
LH
Miller
H L
HL
Salomon
R M
RM
Licinio
J
J
Krystal
J H
JH
Heninger
G R
GR
Charney
D S
DS
D000928:Antidepressive Agents / Q000627:therapeutic use*; D001923:Brain Chemistry / Q000502:physiology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D004311:Double-Blind Method; D006801:Humans; D012008:Recurrence; D012701:Serotonin / Q000502:physiology*
D000928:Antidepressive Agents; D012701:Serotonin