期刊
BIOLOGICAL PSYCHIATRY
卷 56, 期 8, 页码 587-591出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2004.07.018
关键词
tryptophan depletion; depression; antidepressants; positron emission tomography; serotonin; [F-18] MPPF
Background: Recurrence of depressive symptoms after tryptophan depletion (TD) in selective serotonin reuptake inhibitor (SSRI)-treated depression is an important, unexplained phenomenon. With [F-18] MPPF positron emission tomography (PET), serotonin (5-hydroxytryptamine, 5-HT) 1A receptor binding potential (5-HT1ABP) was measured after TD in various brain regions in citalopram-treated depression. This 5-HT1ABP measurement is sensitive to changes in extracellular 5-HT in animal models. Methods: Eight remitted patients with major depressive disorder received [F-18] MPPF PET scans twice: once after TD and once after sham depletion. Behavioral measures were evaluated with the Hamilton Depression Rating Scale and visual analog scales. Results: No effect on regional 5-HT1ABP was observed after TD, despite an 86% decrease in total plasma tryptophan and transient depressive relapse in six of eight patients. Conclusions: Large-magnitude changes in extracellular 5-HT are not crucial for the mood effects observed in SSRI-treated subjects after TD. Therefore, greater consideration must be given to other mechanisms that involve vulnerability to small perturbations in extracellular 5-HT, such as impairment of signal transduction.
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