Serotonergic‘vulnerability’ in affective disorder: a study of the tryptophan depletion test and relationships between peripheral and central serotonin indexes in citalopram‐responders

• Published in: Acta psychiatrica Scandinavica 1998-05, Vol.97 (5), p.374-380
• Main Authors: Åberg‐Wistedt, A., Hasselmark, L., Stain‐Malmgren, R., Apéria, B., Kjellman, B. F., Mathé, A. A.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Biological and medical sciences; Blood Platelets - drug effects; Blood Platelets - metabolism; Brain - drug effects; Brain - metabolism; Citalopram - adverse effects; Citalopram - therapeutic use; Cortisol; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - physiopathology; Double-Blind Method; Female; Humans; Hydrocortisone - blood; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Mood disorders; Personality Inventory; prolactin; Prolactin - blood; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Receptors, Serotonin - blood; Receptors, Serotonin - drug effects; Serotonin - physiology; serotonin receptors; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - therapeutic use; Tryptophan - deficiency; Tryptophan - physiology; tryptophan depletion
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/j.1600-0447.1998.tb10017.x

A double‐blind study of the tryptophan depletion (TD) challenge was performed on a sample consisting of 20 patients with a major depressive disorder in clinical remission after citalopram treatment. TD was induced by the intake of 43 g of an amino acid mixture containing the five large neutral amino acids. The control group received the same mixture, to which 2.3 g tryptophan had been added. Five of the 12 challenged patients showed a worsening of depressive symptoms during the day of the test. In contrast, there was no mood alteration in the eight control patients. Baseline Cortisol levels were significantly higher in responders to TD compared to those in non‐responders and controls. Platelet serotonin‐receptor function and plasma prolactin levels were correlated. There was a significant positive correlation in the baseline data between rated mood state and plasma Cortisol and a significant inverse correlation between related mood state and plasma tryptophan concentration. Thus low mood appeared to be associated with low serotonin precursor availability as well as with high Cortisol levels.