Effect of 5-Hydroxytryptophan on Serum Cortisol Levels in Major Affective Disorders: III. Effect of Antidepressants and Lithium Carbonate

doi:10.1001/archpsyc.1984.01790150081011

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Vol. 41 No. 4, April 1984

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Effect of 5-Hydroxytryptophan on Serum Cortisol Levels in Major Affective Disorders

III. Effect of Antidepressants and Lithium Carbonate

Herbert Y. Meltzer, MD; Martin Lowy, PhD; Alan Robertson, MD; Paul Goodnick, MD; Richard Perline, PhD

Arch Gen Psychiatry. 1984;41(4):391-397.

Abstract

• Serum cortisol levels were significantly increased followingadministration of 5-hydroxytryptophan (5-HTP), 200 mg orally,to patients with affective disorders. A three-to five-week periodof treatment with lithium carbonate or monoamine oxidase (MAO)inhibitor augmented the mean 5-HTP-induced increase in serumcortisol concentration in manic or depressed patients, respectively:tricyclic antidepressant (TCA) and second-generation antidepressanttreatment diminished the mean serum cortisol response in patientswith major depression. These results are consistent with thehypothesis that lithium carbonate may enhance serotonin (5-HT)receptor sensitivity, whereas TCA and second-generation antidepressantsdiminish 5-HT receptor sensitivity. The enhancement of the cortisolresponse to 5-HTP by MAO inhibitors may be due to decreasedmetabolism of 5-HT. It is important to assess the effect ofthymoleptic drug treatment on various responses to biogenicamine precursors or agonists in patients rather than laboratoryanimals.

Author Affiliations

From the Department of Psychiatry, University of Chicago Pritzker School of Medicine, and the Illinois State Psychiatric Institute, Chicago.

Footnotes

Accepted for publication Sept 23, 1983.

Reprint requests to Department of Psychiatry, University ofChicago Pritzker School of Medicine, 950 E 59th St, Chicago,IL 60637 (Dr Meltzer).

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