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Depressive relapse following acute tryptophan depletion in patients with major depressive disorder

A. -Missagh Ghadirian

Department of Psychiatry, McGill University, Montréal, Québec, Canada

Simon N. Young

Department of Psychiatry and School of Dietetics and Human Nutrition, McGill University, Montréal, Québec, Canada

Roberta M. Palmour

Pierre Blier

Karin F. Helmers

Department of Psychiatry, McGill University, Montréal, Québec, Canada

Chawki Benkelfat

Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montréal, Québec, Canada H3 A 1A1; mdbt{at}musica.mcgill.ca

Acute tryptophan depletion (ATD) lowers serotonin synthesis and elicits depressive symptoms in some, though not all, remitted patients with major depressive disorder (MDD). In the present study, eight medication-free remitted patients with MDD, seasonal pattern, were tested twice, once following the ingestion of a tryptophan-containing mixture, once following ATD. ATD significantly increased Hamilton depression scores (p < 0.001). Four of the patients had a family history of psychiatric disorders: substance abuse (n= 4), mood disorders (n= 3) or Cluster B personality disorders (n= 3). The mood-lowering response to ATD was significantly greater in those patients with, than without, affected relatives (p < 0.001). These preliminary findings (1) support the hypothesis that depressed states are related to disturbed serotonin neurotransmission and (2) suggest that depressive symptoms following ATD might identify a subgroup of patients at high genetic risk for disorders associated with affective lability and dysregulated impulsecontrol, conditions thought to be related to low serotonin neurotransmission.

Key Words: impulsivity • major depression • mood • serotonin • suicide

Journal of Psychopharmacology, Vol. 14, No. 3, 284-287 (2000)
DOI: 10.1177/026988110001400317


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