Abstract
Background: Rapid and transient depletion of tryptophan (TRP) causes a brief depressive
relapse in most patients successfully treated with and taking selective serotonin
reuptake inhibitors, but little change in drug-free, symptomatic depressed patients.
This study investigates the effects of TRP depletion in drug-free subjects in clinical
remission from a prior major depressive episode (MDE).
Methods: Twelve subjects with a prior MDE, currently in clinical remission and drug-free
for at least 3 months (patients), and 12 healthy subjects without personal or family
history of Axis I disorder (controls), received TRP depletion. The study was conducted
in a double-blind, controlled [full (102-g) and quarter-strength (25 g) 15-amino acid
drinks], crossover fashion. Behavioral ratings and plasma TRP levels were obtained
prior to, during, and after testing.
Results: All subjects experienced significant depletion of plasma TRP on both test-drinks,
showing a significant dose–response relation. Healthy control subjects had minimal
mood changes, but patients had a depressive response of greater magnitude.
Conclusions: In the context of prior TRP depletion studies with antidepressant-treated,
and drug-free symptomatic depressed patients, these results suggest that depression
may be caused not by an abnormality of 5-HT function, but by dysfunction of other
systems or brain regions modulated by 5-HT.
Keywords
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Article Info
Publication History
Accepted:
April 6,
1999
Received in revised form:
March 30,
1999
Received:
December 7,
1998
Identification
Copyright
© 1999 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
