L-tryptophan augmentation of light therapy in patients with seasonal affective disorder
L-tryptophan augmentation of light therapy in patients with seasonal affective disorder
复制标题
DOI：
10.1177/070674379704200309
复制
发表时间：
1997-04-01
影响因子：
4
通讯作者：
Lamoureux, S
中科院分区：
文献类型：
--
作者：
Lam, RW;Levitan, RD;Lamoureux, S
目的：多达三分之一的季节性情感障碍 (SAD) 患者对光疗没有完全反应。鉴于 SAD 中血清素能失调的证据，我们研究了 I-色氨酸作为光疗无反应者和部分反应者的增强策略的可能作用。方法：符合 DSM-IV SAD 标准的合格无药患者使用标准早晨光疗方案（10000 勒克斯冷白荧光灯，持续 30 分钟）治疗 2 周。部分反应和无反应者接受开放标签 L-色氨酸（1 g，每日 3 次）治疗 2 周，同时继续光疗。基线和随访的评分包括汉密尔顿抑郁评分量表的 29 项结构化访谈指南、SAD 版本 (SIGH-SAD) 和临床总体印象 (CGI) 量表。 结果：16 名患者开始 I-色氨酸增强阶段。两名患者因副作用而在 3 天内停药。在 14 名完成治疗的患者中，添加 L-色氨酸导致平均抑郁评分显着降低。 14 名患者中的 9 名 (64%) 对联合治疗表现出非常好的临床反应，并且副作用极小。结论：这项开放标签研究表明，对于那些对强光治疗反应有限或反应不佳的 SAD 患者，L-色氨酸可能是一种有效的增强策略。需要进一步的安慰剂对照研究来证明疗效。
Objective: Up to one-third of patients with seasonal affective disorder (SAD) do not have full response to light therapy. Given the evidence for serotonergic dysregulation in SAD, we examined the possible role of I-tryptophan as an augmentation strategy for nonresponders and partial responders to light therapy.Method: Eligible drug-free patients meeting DSM-IV criteria for SAD were treated for 2 weeks using a standard morning light therapy regimen (10 000 lux cool-white fluorescent light for 30 minutes). Partial and nonresponders were treated for 2 weeks with open-label l-tryptophan (1 g 3 times daily) while light therapy was continued. Ratings at baseline and follow-up included the 29-item Structured Interview Guide for the Hamilton Depression Rating Scale, SAD version (SIGH-SAD) and the Clinical Global Impression (CGI) scale.Results: Sixteen patients began the I-tryptophan augmentation phase. Two patients discontinued medications within 3 days because of side effects. In the 14 patients completing treatment, the addition of l-tryptophan resulted in significant reduction of mean depression scores. Nine of 14 patients (64%) showed very good clinical responses to combined treatment and minimal side effects.Conclusion: This open-label study suggests that l-tryptophan may be an effective augmentation strategy for those patients with SAD who show limited or poor response to bright light therapy. Further placebo-controlled studies are warranted to demonstrate efficacy.