Maes M, De Ruyter M, Claes R, Bosma G, Suy E
Psychiatric Center Sint Jozef, Munsterbilzen, Belgium.
J Affect Disord. 1987 Jul-Aug;13(1):23-30. doi: 10.1016/0165-0327(87)90070-x.
Baseline cortisol levels at 8:00 a.m. and the cortisol responses at 90 and 120 min after oral administration of 200 mg 5-hydroxytryptophan (5-HTP) (L-isomer, non-enteric-coated) were assessed in 65 depressed inpatients. Patients were categorized according to DSM-III as major (296.22; 296.32; 296.23; 296.33; 296.24; 296.34) and minor (300.40; 309.00; 296.82) depressives. We observed a significant rise of plasma cortisol in patients with major depression at 90 (P = 0.0001) and 120 (P = 0.002) min, but not in patients with minor depression. Patients with major depression showed significantly higher cortisol responses than those with minor depression (P = 0.016). This significant rise of plasma cortisol after 5-HTP could be attributed to sex-linked differences: we observed significant (P = 0.0065) rises in cortisol responses in women with major depression compared to depressed men and women with minor depression. These differences could not be attributed to age, concomitant benzodiazepine use or pre/postmenopausal status. Baseline cortisol correlated negatively with the cortisol response to 5-HTP. The increased cortisol responses in women with major depression remained significant even after the effects of baseline cortisol were partialled out. This rise in cortisol response can be explained by an increased responsiveness of the hypothalamic-pituitary-adrenal axis to 5-HTP.
对65名住院抑郁症患者评估了上午8点的基础皮质醇水平以及口服200毫克5-羟色氨酸（5-HTP，L-异构体，非肠溶衣）后90分钟和120分钟时的皮质醇反应。根据《精神疾病诊断与统计手册》第三版（DSM-III），患者被分为重度（296.22；296.32；296.23；296.33；296.24；296.34）和轻度（300.40；309.00；296.82）抑郁症患者。我们观察到，重度抑郁症患者在90分钟（P = 0.0001）和120分钟（P = 0.002）时血浆皮质醇显著升高，而轻度抑郁症患者则未出现这种情况。重度抑郁症患者的皮质醇反应显著高于轻度抑郁症患者（P = 0.016）。5-HTP后血浆皮质醇的这种显著升高可能归因于性别相关差异：与患有轻度抑郁症的男性和女性相比，我们观察到患有重度抑郁症的女性皮质醇反应显著（P = 0.0065）升高。这些差异不能归因于年龄、同时使用苯二氮卓类药物或绝经前/后状态。基础皮质醇与对5-HTP的皮质醇反应呈负相关。即使排除基础皮质醇的影响后，患有重度抑郁症的女性皮质醇反应的增加仍然显著。皮质醇反应的这种升高可以通过下丘脑-垂体-肾上腺轴对5-HTP反应性的增加来解释。
