Merens W, Booij L, Haffmans Pm Judith, van der Does Ajw
Department of Psychology, Leiden University, Leiden, The Netherlands.
J Psychopharmacol. 2008 Aug;22(6):653-62. doi: 10.1177/0269881107081531. Epub 2008 Feb 28.
It has been well documented that acute tryptophan depletion (ATD) induces symptoms in remitted depressed patients treated with an SSRI. ATD also has effects on cognition, both in patients and in healthy samples. The exact nature of ATD-induced cognitive changes in depression remains unclear. It is also unclear whether cognitive effects can be induced through partial ('low-dose') depletion. The aim of this study is to investigate the differential effects of low-dose and high-dose ATD on emotional information processing and mood in remitted depressed patients. Eighteen remitted depressed patients received high-dose and low-dose ATD in a randomized, double-blind, within-subjects crossover design. Mood was assessed before and after administration of the depletion drink. Five hours after administration, patients conducted tests measuring neutral and emotional information processing. High-dose ATD increased depressive symptoms and induced a temporary depressive 'relapse' in half of the patients. High-dose ATD also decreased the recognition of fear and impaired learning and memory retrieval. The impaired learning occurred only in mood-responders. Low-dose ATD had no effects on mood but speeded the recognition of facial expressions of disgust. Accurate recognition of sad faces at baseline was associated with mood response to ATD. High-dose ATD leads to changes in memory and in the recognition of negative facial expressions in SSRI-treated remitted depressed patients. The effect of low-dose ATD on mood and cognition seems to be quite limited. Emotional information processing at baseline predicts mood-response to ATD.
已有充分文献记载，急性色氨酸耗竭（ATD）会在接受选择性5-羟色胺再摄取抑制剂（SSRI）治疗的缓解期抑郁症患者中诱发症状。ATD对患者以及健康样本的认知也有影响。ATD在抑郁症中诱发的认知变化的确切性质仍不清楚。通过部分（“低剂量”）耗竭是否能诱发认知效应也不清楚。本研究的目的是调查低剂量和高剂量ATD对缓解期抑郁症患者情绪信息处理和情绪的不同影响。18名缓解期抑郁症患者以随机、双盲、受试者内交叉设计接受高剂量和低剂量ATD。在服用耗竭饮料前后评估情绪。服药5小时后，患者进行测量中性和情绪信息处理的测试。高剂量ATD增加了抑郁症状，并在一半患者中诱发了暂时的抑郁“复发”。高剂量ATD还降低了对恐惧的识别，并损害了学习和记忆检索。学习受损仅发生在情绪反应者中。低剂量ATD对情绪没有影响，但加快了对厌恶面部表情的识别。基线时对悲伤面孔的准确识别与对ATD的情绪反应相关。高剂量ATD导致接受SSRI治疗的缓解期抑郁症患者的记忆和负面面部表情识别发生变化。低剂量ATD对情绪和认知的影响似乎相当有限。基线时的情绪信息处理可预测对ATD的情绪反应。
