Vielhaber K, Riemann D, Feige B, Kuelz A, Kirschbaum C, Voderholzer U
Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Germany.
Pharmacopsychiatry. 2005 Mar;38(2):87-94. doi: 10.1055/s-2005-837808.
Tryptophan depletion (TD) has been shown to induce a transient mood-lowering effect in psychiatric patients and susceptible healthy subjects. We investigated the effects of TD on cortisol secretion in psychiatric patients and healthy subjects based on the hypothesis that the potential mood-lowering effects may be associated with increased activity of the hypothalamic-pituitary-adrenal axis, thus leading to a rise of cortisol secretion.
After TD at 18.00 h, salivary cortisol was sampled in the evening and on the following morning. The first study was a randomized, placebo-controlled, crossover study in healthy subjects. Two further open trials in patients with obsessive-compulsive disorder (OCD) and primary insomnia compared the effects of TD on cortisol with baseline conditions.
In healthy subjects, TD significantly diminished cortisol the next morning compared with placebo. In OCD patients and primary insomniacs, cortisol the morning after TD was lowered compared with baseline. Evening cortisol was not affected by TD in any of the groups.
Contrary to expectation, TD led to a comparable decrease of morning cortisol in all groups investigated. However, these findings are consistent with former studies analyzing the impact of antiserotonergic drugs on cortisol secretion. The results underline that the antiserotonergic effects caused by TD may influence cortisol secretion.
色氨酸耗竭（TD）已被证明会在精神病患者和易感健康受试者中诱发短暂的情绪低落效应。我们基于以下假设研究了TD对精神病患者和健康受试者皮质醇分泌的影响，即潜在的情绪低落效应可能与下丘脑-垂体-肾上腺轴活性增加有关，从而导致皮质醇分泌增加。
在18:00进行TD后，于当晚和次日早晨采集唾液皮质醇样本。第一项研究是在健康受试者中进行的随机、安慰剂对照、交叉研究。另外两项针对强迫症（OCD）患者和原发性失眠患者的开放试验比较了TD对皮质醇的影响与基线情况。
在健康受试者中，与安慰剂相比，TD使次日早晨的皮质醇显著降低。在OCD患者和原发性失眠患者中，TD后早晨的皮质醇与基线相比降低。所有组中，夜间皮质醇均未受TD影响。
与预期相反，TD导致所有研究组次日早晨的皮质醇出现类似程度的降低。然而，这些发现与之前分析抗5-羟色胺能药物对皮质醇分泌影响的研究一致。结果强调，TD引起的抗5-羟色胺能效应可能影响皮质醇分泌。
