van Vliet I M, Slaap B R, Westenberg H G, Den Boer J A
Department of Psychiatry, Academic Hospital Utrecht, The Netherlands.
Eur Neuropsychopharmacol. 1996 May;6(2):103-10. doi: 10.1016/0924-977x(95)00070-6.
To investigate the role of serotonin (5-HT) in the pathophysiology of panic disorder (PD) a challenge test with L-5-hydroxytryptophan (5-HTP) was conducted. Seven patients suffering from PD and seven healthy controls received an i.v. challenge with 10 mg, 20 mg and 40 mg 5-HTP and placebo in random order on four different occasions. Before, during and until 2 h after 5-HTP administration anxious and depressive symptomatology was assessed. In addition, plasma levels of 5-HTP, cortisol, and 5-HIAA were measured at several timepoints. During and after infusion of placebo or any of the different dosages of 5-HTP, none of the patients or controls experienced a panic attack or showed an increase in anxiety or depressive symptoms. There was a dose-related increase in side effects, like nausea, dizziness and fatigue. Only infusion with 40 mg 5-HTP led to an increase in plasma cortisol in both patients and controls. The observed increase in plasma cortisol level was higher for patients compared to controls only at 30 min after infusion. In conclusion, stimulation of the serotonergic neuronal system by three different dosages of 5-HTP did not induce panic or anxiety in PD patients and healthy controls. The 5-HT hypersensitivity hypothesis of PD could not be confirmed in the present study.
为研究血清素（5-羟色胺，5-HT）在惊恐障碍（PD）病理生理学中的作用，进行了一项使用L-5-羟色氨酸（5-HTP）的激发试验。7例PD患者和7名健康对照者在4个不同时间段，随机接受静脉注射10mg、20mg和40mg 5-HTP及安慰剂的激发试验。在注射5-HTP前、期间及之后2小时，评估焦虑和抑郁症状。此外，在多个时间点测量血浆中5-HTP、皮质醇和5-羟吲哚乙酸（5-HIAA）的水平。在输注安慰剂或任何不同剂量的5-HTP期间及之后，患者和对照者均未出现惊恐发作，也未表现出焦虑或抑郁症状增加。副作用呈剂量相关增加，如恶心、头晕和疲劳。仅输注40mg 5-HTP导致患者和对照者血浆皮质醇均升高。仅在输注后30分钟时患者血浆皮质醇水平的升高高于对照者。总之，三种不同剂量的5-HTP刺激血清素能神经元系统未在PD患者和健康对照者中诱发惊恐或焦虑。本研究未证实PD的5-HT超敏假说。
