Evans Lynn, Golshan Shahrokh, Kelsoe John, Rapaport Mark, Resovsky Kathryn, Sutton Laura, Gillin J Christian
Department of Psychiatry, University of California, San Diego, CA, USA.
Neuropsychopharmacology. 2002 Dec;27(6):1016-26. doi: 10.1016/S0893-133X(02)00362-7.
Serotonin has been implicated in both sleep and mood regulation. When central serotonin was depleted with a tryptophan-free amino acid drink (TFD), some studies have reported that the antidepressant benefits were reversed in partially remitted patients treated with SSRIs. Other studies showed that the TFD increased rapid eye movement (REM) sleep in both normal males and in remitted depression patients on selective serotonin reuptake inhibitors (SSRIs) without affecting mood. In this study, we administered a TFD to patients with remitted depression who were being treated with bupropion, an antidepressant whose mechanism of action apparently does not affect the serotonin system. We hypothesized that the TFD would increase the propensity for REM sleep without affecting depression ratings. Eight partially remitted depression subjects on bupropion were administered a TFD and a control drink containing tryptophan in double-blind, random order on separate days. The effects of these drinks were monitored with sleep electroencephalograms, mood ratings, and plasma tryptophan measures comparing baseline, TFD, and control nights. The TFDs reduced REM latency and stage 2 percent and increased REM time and percent. Subjective measures of elation, vigor, and friendliness significantly decreased on both TFD and control drinks but depression ratings did not. Plasma levels of tryptophan decreased with the TFD. Although the TFD altered REM sleep, certain mood measures, and plasma tryptophan levels, no relapses into depression were seen with our subjects. Bupropion alone did not affect sleep measures.
血清素与睡眠和情绪调节均有关联。当用不含色氨酸的氨基酸饮料（TFD）使中枢血清素耗竭时，一些研究报告称，在接受选择性5-羟色胺再摄取抑制剂（SSRI）治疗的部分缓解患者中，抗抑郁益处会逆转。其他研究表明，TFD可增加正常男性以及服用SSRI的缓解期抑郁症患者的快速眼动（REM）睡眠，且不影响情绪。在本研究中，我们给正在接受安非他酮治疗的缓解期抑郁症患者服用TFD，安非他酮是一种作用机制显然不影响血清素系统的抗抑郁药。我们假设TFD会增加REM睡眠倾向，而不影响抑郁评分。八名服用安非他酮的部分缓解期抑郁症受试者在不同日期以双盲、随机顺序分别服用TFD和含色氨酸的对照饮料。通过睡眠脑电图、情绪评分以及比较基线、TFD和对照夜晚的血浆色氨酸测量来监测这些饮料的效果。TFD缩短了REM潜伏期和第二阶段百分比，增加了REM时间和百分比。在TFD和对照饮料服用期间，欣快感、活力和友善度的主观测量值均显著下降，但抑郁评分未变。TFD使血浆色氨酸水平降低。尽管TFD改变了REM睡眠、某些情绪测量值以及血浆色氨酸水平，但我们的受试者未出现抑郁症复发情况。单独使用安非他酮不影响睡眠测量值。
