Booij L, Van der Does A J W, Riedel W J
Department of Psychology, Leiden University, Leiden 2333 AK, The Netherlands.
Mol Psychiatry. 2003 Nov;8(12):951-73. doi: 10.1038/sj.mp.4001423.
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.
急性色氨酸耗竭（ATD）、α-甲基-对酪氨酸（AMPT）以及急性苯丙氨酸/酪氨酸耗竭（APTD）。本文回顾了1966年至2002年12月期间人类单胺耗竭研究的结果。证据表明，这三种干预措施都具有特异性，就其对一两种神经递质系统的短期影响而言，而非对大脑蛋白质代谢的总体影响。AMPT程序的特异性稍低，会影响多巴胺和去甲肾上腺素系统。ATD和AMPT的行为效应非常相似。这两种程序对抑郁症患者的症状均无即时影响；然而，两者都会在一些缓解期抑郁症患者中诱发短暂的抑郁症状。效应的程度、反应率和反应质量也具有可比性。尚未对康复的重度抑郁症患者进行APTD研究。尽管存在相似之处，但这些效应也有独特之处，即ATD影响接受血清素能药物治疗的近期缓解患者亚组，而AMPT影响接受去甲肾上腺素能药物治疗的近期缓解患者。证据还表明，ATD和APTD影响不同的认知功能，尤其是不同的记忆系统。很少有研究调查这些程序对患者认知的影响。缓解时间较长的患者也可能易受ATD和AMPT影响，但与先前治疗的关系要弱得多。对于这些患者，个体易感性标志物是抑郁反应更重要的决定因素，这使得这些技术有可能成为抑郁症易感性的有用模型。
