Effects of tryptophan depletion in fully remitted patients with seasonal affective disorder during summer

Neumeister, Alexander; Praschak-Rieder, Nicole; Heßelmann, B.; Vitouch, Oliver; Rauh, Manfred; Barocka, Arnd; Kasper, Siegfried

doi:10.1017/s0033291797006375

Cited by 64 publications

(49 citation statements)

References 24 publications

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“…It has since been shown that eight of 11 SAD patients who were in natural remission during summer responded to ATD. 52 This study also showed that seven of eight SAD patients who reacted to ATD in summer developed a depressive episode during the next winter, whereas two of three patients who did not respond to ATD remained well. 52 In another study on SAD during natural summer remission, 53 six of 12 medication-free patients had a clinically significant increase of symptoms after ATD, but three patients also reacted to sham depletion.…”

Section: Acute Tryptophan Depletionsupporting

confidence: 52%

“…52 This study also showed that seven of eight SAD patients who reacted to ATD in summer developed a depressive episode during the next winter, whereas two of three patients who did not respond to ATD remained well. 52 In another study on SAD during natural summer remission, 53 six of 12 medication-free patients had a clinically significant increase of symptoms after ATD, but three patients also reacted to sham depletion. As the difference was nonsignificant, it was concluded that summer remission is not dependent on plasma Trp levels in the same manner as remission after light therapy.…”

Section: Acute Tryptophan Depletionsupporting

confidence: 52%

“…The clinical significance of response to monoamine depletion procedures is a potentially fruitful area for research, since some encouraging data exist for ATD. 26,52 An area that remains completely unexplored is the relationship between these biological indices of depression vulnerability with psychological vulnerability measures. Recent research based on Beck's cognitive model of depression 132 has yielded a new measure of vulnerability, labeled cognitive reactivity (CR).…”

Section: Discussionmentioning

confidence: 99%

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Monoamine depletion in psychiatric and healthy populations: review

2003

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A number of techniques temporarily lower the functioning of monoamines: acute tryptophan depletion (ATD), alpha-methyl-para-tyrosine (AMPT) and acute phenylalanine/tyrosine depletion (APTD). This paper reviews the results of monoamine depletion studies in humans for the period 1966 until December 2002. The evidence suggests that all three interventions are specific, in terms of their short-term effects on one or two neurotransmitter systems, rather than on brain protein metabolism in general. The AMPT procedure is somewhat less specific, affecting both the dopamine and norepinephrine systems. The behavioral effects of ATD and AMPT are remarkably similar. Neither procedure has an immediate effect on the symptoms of depressed patients; however, both induce transient depressive symptoms in some remitted depressed patients. The magnitude of the effects, response rate and quality of response are also comparable. APTD has not been studied in recovered major depressive patients. Despite the similarities, the effects are distinctive in that ATD affects a subgroup of recently remitted patients treated with serotonergic medications, whereas AMPT affects recently remitted patients treated with noradrenergic medications. The evidence also suggests that ATD and APTD affect different cognitive functions, in particular different memory systems. Few studies investigated cognitive effects of the procedures in patients. Patients who are in remission for longer may also be vulnerable to ATD and AMPT, but the relationship with prior treatment is much weaker. For these patients, individual vulnerability markers are the more important determinants of depressive response, making these techniques potentially useful models of vulnerability to depression. Molecular Psychiatry (2003) 8, 951-973.

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Section: Acute Tryptophan Depletionsupporting

confidence: 52%

Section: Acute Tryptophan Depletionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

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Monoamine depletion in psychiatric and healthy populations: review

2003

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“…Lowering of the serotonin precursor tryptophan by dietary tryptophan depletion causes a 30-60% decrease in brain serotonin content in animals and a transient reappearance of depressive symptoms in remitted patients with seasonal (Lam et al, 1996;Neumeister et al, 1997Neumeister et al, , 1998 and nonseasonal depression (Delgado et al, 1991;Smith et al, 1997). A decrease in synaptic serotonin in depression is further suggested by challenge studies with serotonergic agents (Levitan et al, 1998;Schwartz et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Enhanced Serotonin Transporter Function during Depression in Seasonal Affective Disorder

Willeit

Sitte

Thierry

et al. 2007

Neuropsychopharmacol

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Decreased synaptic serotonin during depressive episodes is a central element of the monoamine hypothesis of depression. The serotonin transporter (5-HTT, SERT) is a key molecule for the control of synaptic serotonin levels. Here we aimed to detect state-related alterations in the efficiency of 5-HTT-mediated inward and outward transport in platelets of drug-free depressed patients suffering from seasonal affective disorder (SAD). 5-HTT turnover rate, a measure for the number of inward transport events per minute, and tyramineinduced, 5-HTT-mediated outward transport were assessed at baseline, after 4 weeks of bright light therapy, and in summer using a case-control design in a consecutive sample of 73 drug-free depressed patients with SAD and 70 nonseasonal healthy controls. Patients were drug-naive or medication-free for at least 6 months prior to study inclusion, females patients were studied in the follicular phase of the menstrual cycle. All participants were genotyped for a 5-HTT-promoter polymorphism (5-HTTLPR) to assess the influence of this polymorphism on 5-HTT parameters. Efficiency of 5-HTT-mediated inward (p ¼ 0.014) and outward (p ¼ 0.003) transport was enhanced in depressed patients. Both measures normalized toward control levels after therapy and in natural summer remission. Changes in outward transport showed a clear correlation with treatment response (r ¼ 0.421, p ¼ 0.001). Changes in inward transport were mediated by changes in 5-HTT transport efficiency rather than affinity or density. 5-HTTLPR was not associated with any of the 5-HTT parameters. In sum, we conclude that the 5-HTT is in a hyperfunctional state during depression in SAD and normalizes after light therapy and in natural summer remission.

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“…From a mechanistic view this result may indicate -methyl-tyrosine to be competing with endogenous tyrosine, resulting in depletion of ND and DA. Perhaps in the absence of adequate tyrosine there is a possibility of decreased synthesis [75]. Tyrosine therapy has resulted in alleviating depression [76].…”

Section: Tyrosinementioning

confidence: 99%

Amino Acids in Pathological Gambling and in its Alleviation: Pharmacological Approaches

Gupta¹

2010

TOADDJ

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Labelling Pathological gambling (PG) with a tag of Socio-Psychological problem more than medical causes hampers its pharmacological treatment. Because of this, its neurobiology has been studied only a little, limited to abnormalities in the serotonergic, noradrenergic and dopaminergic systems. Besides this; studies on the role of precursors of these neurotransmitters are almost negligible. Higher concentrations of known precursors like tryptophan, tyrosine and phenyl alanine have been reported in the CSF of pathological gamblers. In addition to this, recently many other inhibitory and excitatory amino acids like GABA, taurine, aspartic and glutamic acids have been found to be in much higher concentration, providing a basis for the candidate amino acids in the therapy of PG. Many of these amino acids have beneficial actions in a number of CNS problems. On this basis, as most of these amino acids are non-toxic and natural, such amino acids can be used as supplements /compliments in PG therapy. One of these amino acids, taurine, a sulfur containing amino acid which is now part of various energy drinks, anti-ageing and anti-diabetes formulas, mood enhancers and many more alternative medicine applications, also could exert beneficial actions in alleviating PG. Therapy with amino acids also has its own limitations; hence development of pro-drug derivatives of these amino acids may constitute a new class of therapeutic agent for PG. This review is a blended form of synthesis and synopsis about various amino acids in the context of PG, considering their potential utility and providing a provocative stimulus for scientific thinkers.

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Effects of tryptophan depletion in fully remitted patients with seasonal affective disorder during summer

Abstract: The present study demonstrates that SAD patients in remission during the summer are vulnerable to a return of depression when depleted of tryptophan. This finding supports the importance of serotonergic mechanisms in the pathophysiology of SAD.

Cited by 64 publications

References 24 publications

Monoamine depletion in psychiatric and healthy populations: review

Monoamine depletion in psychiatric and healthy populations: review

Enhanced Serotonin Transporter Function during Depression in Seasonal Affective Disorder

Amino Acids in Pathological Gambling and in its Alleviation: Pharmacological Approaches

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