title: Chemoprophylaxis of depressions. An attempt to compare lithium with 5-hydroxytryptophan.
abstract: There are indications that the group of vital ('endogenous') depressions encompasses a subgroup with central 5-HT deficiency and that this factor contributes to the development of the (or some) depressive symptoms instead of resulting from them. In a majority of patients the suspected 5-HT deficiency persists even when the depressive symptoms have disappeared and the medication has been discontinued. This led us to the hypothesis that the disturbed central 5-HT metabolism is not a direct causal, but a predisposing factor. If this is true, then abolition of the suspected 5-HT deficiency, for example with the aid of 5-HTP, can be expected to have a prophylactic effect. This hypothesis was investigated in this study and confirmed. 5-HTP reduces the relapse rate in recurrent vital depressions with a unipolar and those with a bipolar course. This effect would seem to be most pronounced in patients whose disorders of central 5-HT metabolism are persistent. Tentatively it was concluded that 5-HTP seems to be inferior to lithium in bipolar patients and at least equivalent to lithium in unipolar patients. This problem, however, is still under investigation. 5-HTP prophylaxis is the first aimed (i.e. pathological substrate-oriented) type of chemoprophylaxis known in psychiatry.
mesh_terms: D006916:5-Hydroxytryptophan / Q000627:therapeutic use*; D000328:Adult; D003866:Depressive Disorder / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011339:Probenecid; D012008:Recurrence; D012701:Serotonin / Q000378:metabolism
chemical_list: D012701:Serotonin; D006897:Hydroxyindoleacetic Acid; D008094:Lithium; D006916:5-Hydroxytryptophan; D011339:Probenecid