den Boer J A, Westenberg H G
Department of Biological Psychiatry, University Hospital, Utrecht, The Netherlands.
Psychiatry Res. 1990 Mar;31(3):267-78. doi: 10.1016/0165-1781(90)90096-n.
L-5-Hydroxytryptophan (5HTP) was administered to 20 patients suffering from panic disorder and to 20 healthy controls. Subjects received 60 mg 5HTP in 300 ml saline solution. Before, during, and up to 2 hours after 5HTP administration, symptoms of anxiety and depression were assessed. In addition, plasma 5HTP, 3-methoxy-4-hydroxyethylglycol (MHPG), cortisol, beta-endorphin, and melatonin levels were measured at several time points, and the kinetics of 5-hydroxytryptamine (5HT) in blood platelets were measured. During and after the infusion of 5HTP, none of the patients showed an increase in anxiety or depressive symptoms, despite the presence of severe side effects. Some patients even experienced the 5HTP infusion as a relief. In contrast to the patients, nine control subjects reported depressed mood, although no increases in anxiety were noted. In both patients and controls, the 5HTP infusion led to substantial increases in plasma cortisol and beta-endorphin levels, while the plasma MHPG level was unchanged. Plasma melatonin increased significantly after 5HTP administration, suggesting that increasing 5HT availability in man might affect melatonin synthesis. The results of this study are at odds with the hypothesis that there is a supersensitivity of 5HT2 receptors in panic disorder.
将5-羟色氨酸（5HTP）给予20名惊恐障碍患者和20名健康对照者。受试者在300毫升盐溶液中接受60毫克5HTP。在给予5HTP之前、期间以及之后长达2小时，评估焦虑和抑郁症状。此外，在几个时间点测量血浆5HTP、3-甲氧基-4-羟乙氧基乙二醇（MHPG）、皮质醇、β-内啡肽和褪黑素水平，并测量血小板中5-羟色胺（5HT）的动力学。在输注5HTP期间和之后，尽管存在严重的副作用，但没有患者出现焦虑或抑郁症状增加。一些患者甚至将输注5HTP视为一种缓解。与患者不同，9名对照者报告情绪低落，尽管未观察到焦虑增加。在患者和对照者中，输注5HTP均导致血浆皮质醇和β-内啡肽水平大幅升高，而血浆MHPG水平未改变。给予5HTP后血浆褪黑素显著增加，表明增加人体内5HT的可用性可能会影响褪黑素的合成。本研究结果与惊恐障碍中5HT2受体超敏的假设不一致。
