对5-羟色胺再摄取抑制剂有反应的强迫症患者的色氨酸耗竭。
Tryptophan depletion in patients with obsessive-compulsive disorder who respond to serotonin reuptake inhibitors.
作者信息
Barr L C, Goodman W K, McDougle C J, Delgado P L, Heninger G R, Charney D S, Price L H
机构信息
Clinical Neuroscience Research Unit, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven.
出版信息
Arch Gen Psychiatry. 1994 Apr;51(4):309-17. doi: 10.1001/archpsyc.1994.03950040053007.
METHODS
The effects of short-term tryptophan depletion were examined in 15 patients with DSM-III-R obsessive-compulsive disorder who had demonstrated symptom reduction following treatment with serotonin reuptake inhibitors. Patients received a 24-hour, low-tryptophan (160-mg/d) diet followed the next morning by a drink of 15 amino acids. A double-blind, placebo-controlled cross-over design was used.
RESULTS
The diet and the amino acid drink reduced free plasma tryptophan levels by a mean of 84% 5 hours later. Short-term tryptophan depletion did not significantly change mean ratings of obsessions and compulsions. In contrast, mean depression ratings were significantly increased with tryptophan depletion compared with the control (tryptophan-supplemented) testing.
CONCLUSION
Maintenance of serotonin reuptake inhibitor-induced improvement of obsessive and compulsive symptoms, unlike remission of depressive symptoms, may not depend on ongoing short-term availability of serotonin.
方法
对15名符合《精神疾病诊断与统计手册第三版修订本》（DSM-III-R）标准的强迫症患者进行了短期色氨酸耗竭效应的研究，这些患者在接受5-羟色胺再摄取抑制剂治疗后症状有所减轻。患者先接受为期24小时的低色氨酸（160毫克/天）饮食，次日早晨再饮用含15种氨基酸的饮品。采用双盲、安慰剂对照的交叉设计。
结果
5小时后，饮食及氨基酸饮品使血浆游离色氨酸水平平均降低了84%。短期色氨酸耗竭并未显著改变强迫观念与强迫行为的平均评分。相比之下，与对照（补充色氨酸）测试相比，色氨酸耗竭使抑郁平均评分显著升高。
结论
与抑郁症状的缓解不同，5-羟色胺再摄取抑制剂诱导的强迫症状改善的维持可能不依赖于5-羟色胺的持续短期可利用性。
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