Acute tryptophan depletion. Part II: Clinical effects and implications

Australian and New Zealand Journal of Psychiatry

Volumn 39, Issue 7, 2005, Pages 565-574

  Bell, Caroline J ^b   Hood, Sean D ^c   Nutt, David J ^a  

^a UNIVERSITY OF BRISTOL   (United Kingdom)

^b UNIVERSITY OF OTAGO   (New Zealand)

^c UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

Author keywords

Clinical; Psychopharmacology; Serotonin; Tryptophan

Indexed keywords

SEROTONIN; TRYPTOPHAN;

AGGRESSIVENESS; ANXIETY DISORDER; COGNITIVE DEFECT; DEPRESSION; DIET; HUMAN; MEDICAL RESEARCH; METHODOLOGY; REVIEW; SLEEP DISORDER;

ALLELES; ALZHEIMER DISEASE; AUTISTIC DISORDER; BIPOLAR DISORDER; COGNITIVE THERAPY; DEPRESSIVE DISORDER, MAJOR; EATING DISORDERS; FEMALE; HUMANS; HYDROXYINDOLEACETIC ACID; IMPULSE CONTROL DISORDERS; MONOAMINE OXIDASE INHIBITORS; PREMENSTRUAL SYNDROME; PROMOTER REGIONS (GENETICS); QUESTIONNAIRES; SCHIZOPHRENIA; SEROTONIN; SEROTONIN PLASMA MEMBRANE TRANSPORT PROTEINS; SEROTONIN UPTAKE INHIBITORS; SLEEP DISORDERS; SLEEP, REM; TRYPTOPHAN;

EID: 27744511322     PISSN: 00048674     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1440-1614.2005.01628.x     Document Type: Review

References (112)

1. Smith SE, Pihl RO, Young SN, Ervin FR. A test of possible cognitive and environmental influences on the mood lowering effect of tryptophan depletion in normal males. Psychopharmacology 1987; 91:451-457.
2. Young SN, Smith SE, Pihl RO, Ervin FR. Tryptophan depletion causes a rapid lowering of mood in normal males. Psychopharmacology 1985; 87:173-177.
3. Ellenbogen MA, Young SN, Dean P, Palmour RM, Benkelfat C. Mood response to acute tryptophan depletion in healthy volunteers: sex differences and temporal stability. Neuropsychopharmacology 1996; 15:465-474.
4. Weltzin TE, Fernstrom JD, McConaha C, Kaye WH. Acute tryptophan depletion in bulimia: effects on large neutral amino acids. Biological Psychiatry 1994; 35:388-397.
5. Abbott FV, Etienne P, Franklin KB, Morgan MJ, Sewitch MJ, Young SN. Acute tryptophan depletion blocks morphine analgesia in the cold-pressor test in humans. Psychopharmacology 1992; 108:60-66.
6. Benkelfat C, Ellenbogen MA, Dean P, Palmour RM, Young SN. Mood-lowering effect of tryptophan depletion. Enhanced susceptibility in young men at genetic risk for major affective disorders. Archives of General Psychiatry 1994; 51:687-697.
7. Carpenter LL, Anderson GM, Pelton GH et al. Tryptophan depletion during continuous CSF sampling in healthy human subjects. Neuropsychopharmacology 1998; 19:26-35.
8. Danjou P, Hamon M, Lacomblez L, Warot D, Kecskemeti S, Puech AJ. Psychomotor, subjective and neuroendocrine effects of acute tryptophan depletion in the healthy volunteer. Psychiatrie et Psychobiologie 1990; 5:31-38.
9. Knott VJ, Howson AL, Perugini M, Ravindran AV, Young SN. The effect of acute tryptophan depletion and fenfluramine on quantitative EEG and mood in healthy male subjects. Biological Psychiatry 1999; 46:229-238.
10. Oldman AD, Walsh AES, Salkovskis P, Laver DA, Cowen PJ. Effect of acute tryptophan depletion on mood and appetite in healthy female volunteers. Journal of Psychopharmacology 1994; 8:8-13.
11. Salomon RM, Miller HL, Krystal JH, Heninger GR, Charney DS. Lack of behavioral effects of monoamine depletion in healthy subjects. Biological Psychiatry 1997; 41:58-64.
12. Shansis FM, Busnello JV, Quevedo J et al. Behavioural effects of acute tryptophan depletion in healthy male volunteers. Journal of Psychopharmacology 2000; 14:157-163.
13. Smith KA, Clifford EM, Hockney RA, Clark DM, Cowen PJ. Effect of tryptophan depletion on mood in male and female volunteers: a pilot study. Human Psychopharmacology 1997; 12:111-117.
14. Menkes DB, Coates DC, Fawcett JP. Acute tryptophan depletion aggravates premenstrual syndrome. Journal of Affective Disorders 1994; 32:37-44.
15. Nishizawa S, Benkelfat C, Young SN et al. Differences between males and females in rates of serotonin synthesis in human brain. Proceedings of the National Academy of Sciences of the United States of America 1997; 94:5308-5313.
16. Klaassen T, Riedel WJ, van Someren A, Deutz NE, Honig A, van Praag HM. Mood effects of 24-hour tryptophan depletion in healthy first-degree relatives of patients with affective disorders. Biological Psychiatry 1999; 46:489-497.
17. Quintin P, Benkelfat C, Launay JM et al. Clinical and neurochemical effect of acute tryptophan depletion in unaffected relatives of patients with bipolar affective disorder. Biological Psychiatry 2001; 50:184-190.
18. Ellenbogen MA, Young SN, Dean P, Palmour RM, Benkelfat C. Acute tryptophan depletion in healthy young women with a family history of major affective disorder. Psychological Medicine 1999; 29:35-46.
19. Neumeister A, Konstantinidis A, Stastny J et al. Association between serotonin transporter gene promoter polymorphism (5HTTLPR) and behavioral responses to tryptophan depletion in healthy women with and without family history of depression. Archives of General Psychiatry 2002; 59:613-620.
20. Collier DA, Stober G, Li T et al. A novel functional polymorphism within the promoter of the serotonin transporter gene: possible role in susceptibility to affective disorders. Molecular Psychiatry 1996; 1:453-460.
21. Heils A, Mossner R, Lesch KP. The human serotonin transporter gene polymorphism - basic research and clinical implications. Journal of Neural Transmission 1997; 104:1005-1014.
22. Barr LC, Heninger GR, Goodman W, Charney DS, Price LH. Effects of fluoxetine administration on mood response to tryptophan depletion in healthy subjects. Biological Psychiatry 1997; 41:949-954.
23. Delgado PL, Price LH, Miller HL et al. Serotonin and the neurobiology of depression. Effects of tryptophan depletion in drug-free depressed patients. Archives of General Psychiatry 1994; 51:865-874.
24. Neumeister A, Praschak-Rieder N, Hesselmann B et al. Rapid tryptophan depletion in drug-free depressed patients with seasonal affective disorder. American Journal of Psychiatry 1997; 154:1153-1155.
25. Price LH, Malison RT, McDougle CJ, McCance-Katz EF, Owen KR, Heninger GR. Neurobiology of tryptophan depletion in depression: effects of m-chlorophenylpiperazine (mCPP). Neuropsychopharmacology 1997; 17:342-350.
26. Price LH, Malison RT, McDougle CJ, Pelton GH, Heninger GR. The neurobiology of tryptophan depletion in depression: effects of intravenous tryptophan infusion. Biological Psychiatry 1998; 43:339-347.
27. Bel N, Artigas F. Reduction of serotonergic function in rat brain by tryptophan depletion: effects in control and fluvoxamine-treated rats. Journal of Neurochemistry 1996; 67:669-676.
28. Åberg-Wistedt A, Hasselmark L, Stain-Malmgren R, Aperia B, Kjellman BF, Mathe AA. Serotonergic 'vulnerability' in affective disorder: a study of the tryptophan depletion test and relationships between peripheral and central serotonin indexes in citalopram-responders. Acta Psychiatrica Scandinavica 1998; 97:374-380.
29. Delgado PL, Charney DS, Price LH, Aghajanian GK, Landis H, Heninger GR. Serotonin function and the mechanism of antidepressant action. Reversal of antidepressant-induced remission by rapid depletion of plasma tryptophan. Archives of General Psychiatry 1990; 47:411-418.
30. Delgado PL, Price LH, Miller HL et al. Rapid serotonin depletion as a provocative challenge test for patients with major depression: relevance to antidepressant action and the neurobiology of depression. Psychopharmacology Bulletin 1991; 27:321-330.
31. Delgado PL, Miller HL, Salomon RM et al. Tryptophan-depletion challenge in depressed patients treated with desipramine or fluoxetine: implications for the role of serotonin in the mechanism of antidepressant action. Biological Psychiatry 1999; 46:212-220.
32. Bremner JD, Innis RB, Salomon RM et al. Positron emission tomography measurement of cerebral metabolic correlates of tryptophan depletion-induced depressive relapse. Archives of General Psychiatry 1997; 54:364-374.
33. Smith KA, Morris JS, Friston KJ, Cowen PJ, Dolan RJ. Brain mechanisms associated with depressive relapse and associated cognitive impairment following acute tryptophan depletion. British Journal of Psychiatry 1999; 174:525-529.
34. Spillmann MK, Van der Does AJW, Rankin MA et al. Tryptophan depletion in SSRI-recovered depressed outpatients. Psychopharmacology 2001; 155:123-127.
35. Moore P, Gillin C, Bhatti T et al. Rapid tryptophan depletion, sleep electroencephalogram, and mood in men with remitted depression on serotonin reuptake inhibitors. Archives of General Psychiatry 1998; 55:534-539.
36. Lam RW, Zis AP, Grewal A, Delgado PL, Charney DS, Krystal JH. Effects of rapid tryptophan depletion in patients with seasonal affective disorder in remission after light therapy. Archives of General Psychiatry 1996; 53:41-44.
37. Neumeister A, Praschak-Rieder N, Hesselmann B et al. Effects of tryptophan depletion in fully remitted patients with seasonal affective disorder during summer. Psychological Medicine 1998; 28:257-264.
38. Van der Does AJW. The effects of tryptophan depletion on mood and psychiatric symptoms. Journal of Affective Disorders 2001; 64:107-119.
39. Moreno FA, Heninger GR, McGahuey CA, Delgado PL. Tryptophan depletion and risk of depression relapse: a prospective study of tryptophan depletion as a potential predictor of depressive episodes. Biological Psychiatry 2000; 48:327-329.
40. Leyton M, Young SN, Blier P et al. The effect of tryptophan depletion on mood in medication-free, former patients with major affective disorder. Neuropsychopharmacology 1997; 16:294-297.
41. Booji L, Van der Does W, Benkelfat C et al. Predictors of mood response to acute tryptophan depletion: a reanalysis. International Journal of Neuropsychopharmacology 2002; 5:S201.
42. Miller HL, Delgado PL, Salomon RM et al. Clinical and biochemical effects of catecholamine depletion on antidepressant-induced remission of depression. Archives of General Psychiatry 1996; 53:117-128.
43. O'Reardon JP, Chopra MP, Bergan A, Gallop R, J DR, Crits-Christoph P. Response to tryptophan depletion in major depression treated with either cognitive therapy or selective serotonin reuptake inhibitor antidepressants. Biological Psychiatry 2004; 55:957-959.
44. Evans L, Golshan S, Kelsoe J et al. Effects of rapid tryptophan depletion on sleep electroencephalogram and mood in subjects with partially remitted depression on bupropion. Neuropsychopharmacology 2002; 27:1016-1026.
45. Cassidy F, Murry E, Weiner RD, Carroll BJ. Lack of relapse with tryptophan depletion following successful treatment with ECT. American Journal of Psychiatry 1997; 154:1151-1152.
46. Smith KA, Fairburn CG, Cowen PJ. Relapse of depression after rapid depletion of tryptophan. Lancet 1997; 349:915-919.
47. Leyton M, Young SN, Pihl RO et al. Effects on mood of acute phenylalanine/tyrosine depletion in healthy women. Neuropsychopharmacology 2000; 22:52-63.
48. Moreno FA, Gelenberg AJ, Heninger GR et al. Tryptophan depletion and depressive vulnerability. Biological Psychiatry 1999; 46:498-505.
49. Lam RW, Bowering TA, Tam EM et al. Effects of rapid tryptophan depletion in patients with seasonal affective disorder in natural summer remission. Psychological Medicine 2000; 30:79-87.
50. Smith KA, Fairburn CG, Cowen PJ. Symptomatic relapse in bulimia nervosa following acute tryptophan depletion. Archives of General Psychiatry 1999; 56:171-176.
51. Moreno FA, Rowe DC, Kaiser B et al. Association between a serotonin transporter promoter region polymorphism and mood response during tryptophan depletion. Molecular Psychiatry 2002; 7:213-216.
52. Pierucci-Lagha A, Feinn R, Modesto-Lowe V et al. Effects of rapid tryptophan depletion on mood and urge to drink in patients with co-morbid major depression and alcohol dependence. Psychopharmacology 2004; 171:340-348.
53. Lenzinger E, Neumeister A, Praschak-Rieder N et al. Behavioral effects of tryptophan depletion in seasonal affective disorder associated with the serotonin transporter gene? Psychiatry Research 1999; 85:241-246.
54. Neumeister A, Habeler A, Praschak-Rieder N, Willeit M, Kasper S. Tryptophan depletion: a predictor of future depressive episodes in seasonal affective disorder? International Clinical Psychopharmacology 1999; 14:313-315.
55. Goddard AW, Charney DS, Germine M et al. Effects of tryptophan depletion on responses to yohimbine in healthy human subjects. Biological Psychiatry 1995; 38:74-85.
56. Klaassen T, Klumperbeek J, Deutz NE, van Praag HM, Griez E. Effects of tryptophan depletion on anxiety and on panic provoked by carbon dioxide challenge. Psychiatry Research 1998; 77:167-174.
57. 2-induced anxiety in patients with panic disorder and normal volunteers. British Journal of Psychiatry 2000; 176:182-188.
58. Park SB, Coull JT, McShane RH et al. Tryptophan depletion in normal volunteers produces selective impairments in learning and memory. Neuropharmacology 1994; 33: 575-588.
59. Cleare AJ, Bond AJ. The effect of tryptophan depletion and enhancement on subjective and behavioural aggression in normal male subjects. Psychopharmacology 1995; 118:72-81.
60. Oldman A, Walsh A, Salkovskis P, Fairburn CG, Cowen PJ. Biochemical and behavioural effects of acute tryptophan depletion in abstinent bulimic subjects: a pilot study. Psychological Medicine 1995; 25:995-1001.
61. Bhatti T, Gillin JC, Seifritz E et al. Effects of a tryptophan-free amino acid drink challenge on normal human sleep electroencephalogram and mood. Biological Psychiatry 1998; 43:52-59.
62. Koszycki D, Zacharko RM, Le Melledo JM, Young SN, Bradwejn J. Effect of acute tryptophan depletion on behavioral, cardiovascular, and hormonal sensitivity to cholecystokinin-tetrapeptide challenge in healthy volunteers. Biological Psychiatry 1996; 40:648-655.
63. Kent JM, Coplan JD, Martinez J, Karmally W, Papp LA, Gorman JM. Ventilatory effects of tryptophan depletion in panic disorder: a preliminary report. Psychiatry Research 1996; 64:83-90.
64. Mortimore C, Connell J, Van F. Acute tryptophan depletion in healthy human subjects: effects on two anxiety paradigms. Journal of Psychopharmacology 1997; 11:A26.
65. Harmer CJ, Rogers RD, Tunbridge E, Cowen PJ, Goodwin GM. Tryptophan depletion decreases the recognition of fear in female volunteers. Psychopharmacology 2003; 167:411-417.
66. Goddard AW, Sholomskas DE, Walton KE et al. Effects of tryptophan depletion in panic disorder. Biological Psychiatry 1994; 36:775-777.
67. Schruers K, Klaassen T, Pols H, Overbeek T, Deutz NEP, Griez E. Effects of tryptophan depletion on carbon dioxide provoked panic in panic disorder patients. Psychiatry Research 2000; 93:179-187.
68. Bell C, Forshall S, Adrover M et al. Does 5-HT restrain panic? A tryptophan depletion study in panic disorder patients recovered on paroxetine. Journal of Psychopharmacology 2002; 16:5-14.
69. Argyropoulos S, Hood SD, Adrover M et al. Tryptophan depletion reverses the therapeutic effect of selective serotonin reuptake inhibitors in social anxiety disorder. Biological Psychiatry 2004; 56:503-509.
70. Smeraldi E, Diaferia G, Erzegovesi S, Lucca A, Bellodi L, Moja EA. Tryptophan depletion in obsessive-compulsive patients. Biological Psychiatry 1996; 40:398-402.
71. Huwig-Poppe C, Voderholzer U, Backhaus J, Riemann D, Konig A, Hohagen F. The tryptophan depletion test: impact on sleep in health subjects and patients with obsessive-compulsive disorder. In: Huether et al., ed. Tryptophan, serotonin and melatonin: basic aspects and applications. New York: Plenum, 1999:35-42.
72. Barr LC, Goodman WK, McDougle CJ et al. Tryptophan depletion in patients with obsessive-compulsive disorder who respond to serotonin reuptake inhibitors. Archives of General Psychiatry 1994; 51:309-317.
73. Riedel WJ, Klaassen T, Deutz NE, van Someren A, van Praag HM. Tryptophan depletion in normal volunteers produces selective impairment in memory consolidation. Psychopharmacology 1999; 141:362-369.
74. Rubinsztein JS, Rogers RD, Riedel WJ, Mehta MA, Robbins TW, Sahakian BJ. Acute dietary tryptophan depletion impairs maintenance of 'affective set' and delayed visual recognition in healthy volunteers. Psychopharmacology 2001; 154: 319-326.
75. Rogers RD, Blackshaw AJ, Middleton HC et al. Tryptophan depletion impairs stimulus-reward learning while methylphenidate disrupts attentional control in healthy young adults: implications for the monoaminergic basis of impulsive behaviour. Psychopharmacology 1999; 146:482-491.
76. Robbins TW. Chemical neuromodulation of frontal-executive functions in humans and other animals. Experimental Brain Research 2000; 133:130-138.
77. Porter RJ, Lunn BS, O'Brien JT. Effects of acute tryptophan depletion on cognitive function in Alzheimer's disease and in the healthy elderly. Psychological Medicine 2003; 33:41-49.
78. Coull JT, Sahakian BJ, Middleton HC et al. Differential effects of clonidine, haloperidol, diazepam and tryptophan depletion on focused attention and attentional search. Psychopharmacologia 1995; 121:222-230.
79. Schmitt JAJ, Jorissen BL, Sobczak S et al. Tryptophan depletion impairs memory consolidation but improves focussed attention in healthy young volunteers. Journal of Psychopharmacology 2000; 14:21-29.
80. Gallagher P, Massey AE, Young AH, McAllister-Williams RH. Effects of acute tryptophan depletion on executive function in healthy male volunteers. BMC Psychiatry 2003; 3:10.
81. Klaassen T, Riedel WJ, Deutz NE, Van Praag HM. Mood congruent memory bias induced by tryptophan depletion. Psychological Medicine 2002; 32:167-172.
82. Murphy FC, Smith KA, Cowen PJ, Robbins TW, Sahakian BJ. The effects of tryptophan depletion on cognitive and affective processing in healthy volunteers. Psychopharmacology 2002; 163:42-53.
83. Matrenza C, Hughes JM, Kemp AH, Wesnes KA, Harrison BJ, Nathan PJ. Simultaneous depletion of serotonin and catecholamines impairs sustained attention in healthy female subjects without affecting learning and memory. Journal of Psychopharmacology 2004; 18:21-31.
84. Harrison BJ, Olver JS, Norman TR, Burrows GD, Wesnes KA, Nathan PJ. Selective effects of acute serotonin and catecholamine depletion on memory in healthy women. Journal of Psychopharmacology 2004; 18:32-40.
85. Riedel WJ. Cognitive changes after acute tryptophan depletion: what can they tell us? Psychological Medicine 2004; 34:3-8.
86. Benca RM, Obermeyer WH, Thisted RA, Gillin JC, Kupfer DJ, Reynolds CF III. Sleep and psychiatric disorders: a meta-analysis. Archives of General Psychiatry 1992; 49:651-670.
87. Wilson SJ, Bell C, Coupland NJ, Nutt DJ. Sleep changes during long-term treatment of depression with fluvoxamine - a home-based study. Psychopharmacology 2000; 149:360-365.
88. Voderholzer U, Hornyak M, Thiel B et al. Impact of experimentally induced serotonin deficiency by tryptophan depletion on sleep EEG in healthy subjects. Neuropsychopharmacology 1998; 18:112-124.
89. Landolt HP, Kelsoe JR, Rapaport MH, Gillin JC. Rapid tryptophan depletion reverses phenelzine-induced suppression of REM sleep. Journal of Sleep Research 2003; 12:13-18.
90. Brown GL, Ebert MH, Goyer PF et al. Aggression, suicide, and serotonin: relationships to CSF amine metabolites. American Journal of Psychiatry 1982; 139:741-746.
91. Virkkunen M, Kallio E, Rawlings R et al. Personality profiles and state aggressiveness in Finnish alcoholic, violent offenders, fire setters, and healthy volunteers. Archives of General Psychiatry 1994; 51:28-33.
92. Young SN, Pihl RO, Ervin FR. The effect of altered tryptophan levels on mood and behavior in normal human males. Clinical Neuropharmacology 1988; 11 (Suppl 1):S207-S215.
93. Walderhaug E, Lunde H, Nordvik JE, Landrø NI, Refsum H, Magnusson A. Lowering of serotonin by rapid tryptophan depletion increases impulsiveness in normal individuals. Psychopharmacology 2002; 164:385-391.
94. Wingrove J, Bond AJ, Cleare AJ. Tryptophan enhancement/depletion and reactions to failure on a cooperative computer game. Neuropsychopharmacology 1999; 21:755-764.
95. Bjork JM, Dougherty DM, Moeller FG, Swann AC. Differential behavioral effects of plasma tryptophan depletion and loading in aggressive and nonaggressive men. Neuropsychopharmacology 2000; 22:357-369.
96. Schmeck K, Sadigorsky S, Englert E et al. Mood changes following acute tryptophan depletion in healthy adults. Psychopathology 2002; 35:234-240.
97. Porter RJ, Lunn BS, Walker LL, Gray JM, Ballard CG, O'Brien JT. Cognitive deficit induced by acute tryptophan depletion in patients with Alzheimer's disease. American Journal of Psychiatry 2000; 157:638-640.
98. Yatham LN, Shiah IS, Lam RW, Tam EM, Zis AP. Hypothermic, ACTH, and cortisol responses to ipsapirone in patients with mania and healthy controls. Journal of Affective Disorders 1999; 54:295-301.
99. Wood AJ. A review of the biochemical and neuropharmacological actions of lithium. Biological Psychiatry 1987; 22:1274-1276.
100. Cassidy F, Murry E, Carroll BJ. Tryptophan depletion in recently manic patients treated with lithium. Biological Psychiatry 1998; 43:230-232.
101. Cappiello A, Sernyak MJ, Malison RT, McDougle CJ, Heninger GR, Price LH. Effects of acute tryptophan depletion in lithium-remitted manic patients: a pilot study. Biological Psychiatry 1997; 42:1076-1078.
102. Hughes JH, Dunne F, Young AH. Effects of acute tryptophan depletion on mood and suicidal ideation in bipolar patients symptomatically stable on lithium. British Journal of Psychiatry 2000; 177:447-451.
103. Rosse RB, Schwartz BL, Zlotolow S et al. Effect of a low-tryptophan diet as an adjuvant to conventional neuroleptic therapy in schizophrenia. Clinical Neuropharmacology 1992; 15:129-141.
104. D'Souza D, Gil R, Abi-Draghjam A. Tryptophan depletion paradigm: implications for schizophrenia. Biological Psychiatry 1994; 35:703.
105. Sharma RP, Shapiro LE, Kamath SK, Soll EA, Watanabe MD, Davis JM. Acute dietary tryptophan depletion: effects on schizophrenic positive and negative symptoms. Neuropsychobiology 1997; 35:5-10.
106. Golightly KL, Lloyd JA, Hobson JE, Mercer G, Young AH. Effects of tryptophan depletion on cognition in schizophrenia. Journal of Psychopharmacology 1999; 13:A54.
107. George TP, Potenza MN, Degen K, Sernyak MJ, Woods S, McDougle CJ. Acute tryptophan depletion in schizophrenic patients treated with clozapine. Archives of General Psychiatry 2002; 59:291-292.
108. Weltzin TE, Fernstrom MH, Fernstrom JD, Neuberger SK, Kaye WH. Acute tryptophan depletion and increased food intake and irritability in bulimia nervosa. American Journal of Psychiatry 1995; 152:1668-1671.
109. Kaye WH, Gendall KA, Fernstrom MH, Fernstrom JD, McConaha CW, Weltzin TE. Effects of acute tryptophan depletion on mood in bulimia nervosa. Biological Psychiatry 2000; 47:151-157.
110. Kaye WH, Barbarich NC, Putnam K et al. Anxiolytic effects of acute tryptophan depletion in anorexia nervosa. International Journal of Eating Disorders 2003; 33:257-267; discussion 268-270.
111. McDougle CJ, Naylor ST, Cohen DJ, Aghajanian GK, Heninger GR, Price LH. Effects of tryptophan depletion in drag-free adults with autistic disorder. Archives of General Psychiatry 1996; 53:993-1000.
112. Charney DS. Drug discovery for major psychiatric disorders: unipolar. In: 16th European College of Neurospychopharmacology Congress; October 2003, Prague, Czech Republic.