Tryptophan and tyrosine availability and response to antidepressant treatment in major depression.
BACKGROUND
It has been suggested that the ratio of tryptophan (TRP) and tyrosine (TYR) to other large neutral amino acids may predict response to antidepressant drugs with predominantly serotonergic compared with predominantly noradrenergic activity and that this may be clinically useful.


METHODS
147 subjects with a DSM-III-R diagnosis of major depression underwent a detailed clinical evaluation and prior to treatment had baseline measures of TRP, TYR and other large neutral amino acids (LNAA), prolactin and cortisol. Subjects entered a 6-week randomised treatment trial comparing fluoxetine and nortriptyline.


RESULTS
There was no main effect on 6-week outcome of TRP/LNAA ratio or TYR/LNAA ratio and no interaction between these factors and treatment (fluoxetine vs nortriptyline).


CONCLUSIONS
Alterations in antidepressant dose were allowed therefore possibly reducing the effect of TRP or TYR availability on response.


CONCLUSIONS
Previous findings that TRP/LNAA and TYR/LNAA ratios may predict differential response to antidepressants were not replicated and neither was our previous finding of a complex relationship between TRP/LNAA and baseline prolactin in predicting 6-week response.
Porter
Richard J
RJ
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, P.O. Box 4345, Christchurch, New Zealand. richard.porter@chmeds.ac.nz
Mulder
Roger T
RT
Joyce
Peter R
PR
Luty
Suzanne E
SE
D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D021542:Amino Acids, Neutral / Q000097:blood / Q000187:drug effects; D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology / Q000627:therapeutic use; D002940:Circadian Rhythm; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005473:Fluoxetine / Q000494:pharmacology / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D008297:Male; D009661:Nortriptyline / Q000494:pharmacology / Q000627:therapeutic use*; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014364:Tryptophan / Q000097:blood* / Q000187:drug effects; D014443:Tyrosine / Q000097:blood* / Q000187:drug effects / Q000378:metabolism
D018759:Adrenergic Uptake Inhibitors; D021542:Amino Acids, Neutral; D000929:Antidepressive Agents, Tricyclic; D005473:Fluoxetine; D006854:Hydrocortisone; D009661:Nortriptyline; D011388:Prolactin; D017367:Selective Serotonin Reuptake Inhibitors; D014364:Tryptophan; D014443:Tyrosine