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L-tryptophan and depressive illness: a valuable adjunct to therapy?

  • Donald Eccleston (a1)
Extract

L-tryptophan is an essential amino acid in human nutrition. The minimum daily requirement for adults is in the range of 175 to 250 mg daily and this is normally exceeded in the average western diet which contains 600 to 1000 mg. Excess tryptophan is normally metabolised through the kynurenine pathway and only 1–2% of tryptophan in the diet is converted to 5-HT. The concept that 5-HT had a part to play in depressive illness evolved after the original observation by Ashcroft & Sharman in 1960 that patients with severe depressive illness had lower levels of the metabolite of 5-HT in cerebrospinal fluid compared with controls. In addition, early papers on the therapeutic efficacy of tryptophan suggested that it was potentially as successful as ECT.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Ashcroft, G. W. & Sharman, D. F. (1960) 5-Hydroxyindoles in human cerebrospinal fluids. Nature, 186, 1050.
Barker, W., Scott, J. & Eccleston, D. (1987) The Newcastle chronic depression: results of a treatment regime. International Clinical Psychopharmacology, 2, 261.
Bennie, E. (1982) Mianserin hydrochloride and L-tryptophan compared in depressive illness. British Journal of Clinical and Social Psychiatry, 1, 9091.
Chouinard, G., Young, S. N., Annable, L. & Sourkes, T. L. (1979) Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatrica Scandinavica, 59, 395414.
Delgado, P. L., Charney, D. S., Price, L. H. et al (1990) Serotonin function and the mechanism of antidepressant action. Archives of General Psychiatry, 47, 411418.
Ferrier, I. N., Eccleston, D., Moore, B. M. et al (1990) Relapse of chronic depressives on withdrawal of L-tryptophan. Lancet, 336, 380381.
Hale, A., Proctor, A. W. & Bridges, P. K. (1987) Clomipramine, tryptophan and lithium in combination for resistant endogenous depression: seven case studies. British Journal of Psychiatry, 143, 213217.
Hertzman, P. A., Blevine, W. L., Mayer, J. et al (1990) Association of the eosinophilia-myalgia syndrome with the ingestion of tryptophan. New England Journal of Medicine, 322, 869873.
Jaffe, G. & Grimshaw, J. (1985) A placebo-controlled comparison of L-tryptophan and amitriptyline in the treatment of depressive illness in general practice. British Journal of Clinical and Social Psychiatry, 3, 5155.
Swinbanks, D. & Anderson, C. (1992) Search for contaminant in EMS outbreak goes slowly. Nature, 358, 96.
Thompson, J., Rankin, H., Ashcroft, G. W. et al (1982) The treatment of depression in general practice: A comparison of L-tryptophan, amitriptyline, and a combination of L-tryptophan and amitriptyline with placebo. Psychological Medicine, 12, 741751.
Young, S. N., Scott, E., Smith, E. et al (1985) Tryptophan depletion causes a rapid lowering of mood in normal males. Psychopharmacology, 87, 173177.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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L-tryptophan and depressive illness: a valuable adjunct to therapy?

  • Donald Eccleston (a1)
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