Hoes M J, Sijben N
Psychopharmacology (Berl). 1981;75(4):346-9. doi: 10.1007/BF00435850.
Xanthurenic acid is a metabolite of L-tryptophanicotinic acid ribonucleotide biosynthesis. The excretion of xanthurenic acid from urine 24 h after ingestion of 5 g L-tryptophan is increased in depressive patients, and 17-hydroxycorticosteroids are considered of primary importance to this disorder. However, in this study, the excretion of xanthurenic acid and 17-hydroxycorticosteroids did not correlate with the scores of the Raskin depression scale, Hamilton depression scale, Zung depression scale, or the Zung anxiety scale in depressive patients. The patients were treated with either pyridoxine plus L-tryptophan, a presumably serotonin-enhancing treatment (n = 10) or maprotiline, a noradrenaline-enhancing drug (n = 10). Repeated measurements showed no differences between treatments after 2 or 4 weeks of treatment. The improvement in xanthurenic acid excretion precedes clinical improvements in depression. The excretion of xanthurenic acid only at 2 weeks correlated significantly with the anxiety and depression scores at 4 weeks, making prediction of clinical improvement possible. The neurobiological mode of action on noradrenergic or serotonergic neurons of antidepressant medication is of questionable significance to their therapeutic effect.
黄尿酸是L-色氨酸-烟酸核糖核苷酸生物合成的一种代谢产物。在摄入5g L-色氨酸24小时后，抑郁症患者尿液中黄尿酸的排泄量会增加，并且17-羟皮质类固醇被认为对这种病症至关重要。然而，在本研究中，抑郁症患者尿液中黄尿酸和17-羟皮质类固醇的排泄量与拉斯金抑郁量表、汉密尔顿抑郁量表、zung抑郁量表或zung焦虑量表的得分并无关联。患者接受了两种治疗，一种是吡哆醇加L-色氨酸，一种推测可增强血清素的治疗方法（n = 10），另一种是马普替林，一种增强去甲肾上腺素的药物（n = 10）。重复测量显示，治疗2周或4周后，两种治疗方法之间没有差异。黄尿酸排泄量的改善先于抑郁症的临床改善。仅在2周时黄尿酸的排泄量与4周时的焦虑和抑郁评分显著相关，使得预测临床改善成为可能。抗抑郁药物对去甲肾上腺素能或血清素能神经元的神经生物学作用方式对其治疗效果的意义存疑。
