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Brain 5-HT function in bipolar affective disorder

Published online by Cambridge University Press:  18 September 2015

A.H. Young*
Affiliation:
School of Neurosciences and Psychiatry, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
J.H. Hughes
Affiliation:
School of Neurosciences and Psychiatry, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
C.H. Ashton
Affiliation:
School of Neurosciences and Psychiatry, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
*
Stanley Foundation Research Center School of Neurosciences and Psychiatry, University of Newcastle upon Tyne, Leazes Wing, The Royal Victoria Infirmary Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United KingdomTel 44-0191-232-5131 extn 24258, Fax 44-0191-227-5108, E-mail A.H.Young@ncl.ac.uk

Abstract

Background: Previous studies suggest that brain serotonin neurotransmission may mediate the actions of lithium carbonate. Acute tryptophan depletion (ATD) reduces brain serotonin and allows the study of this neurotransmitter in patient groups. Serotonin modulates electroencephalographic (EEG) activity, which is abnormal in bipolar disorder, and EEG abnormalities persist in euthymic bipolar patients. The EEG may therefore be a sensitive marker of 5-HT function in bipolar disorder.

Aims: This study examined the effects of ATD on mood, suicidal ideation and EEG activity in bipolar patients who were symptomatically stable on lithium.

Methods: 19 subjects satisfying DSM-IV criteria for bipolar I disorder participated in a within-subject, double-blind, placebo-controlled random-order crossover study. Following acute tryptophan depletion (induced by a 100g amino acid drink following an overnight fast) symptoms were evaluated, quantitative power spectrum brain mapping and measurement of auditory evoked potentials were carried out.

Results: ATD produced a significant fall in the amplitude of N1P2 and P300 components of the auditory evoked potential, but no significant changes in the power spectrum. There was an 83% reduction in plasma tryptophan (p<0.05, paired t-test) after the depleting but not the control drink. No significant changes in mood or suicidally scores were recorded after ATD.

Conclusions: ATD attenuates auditory evoked potentials in bipolar disorder but does not reverse lithium's effects on mood and suicidally in bipolar disorder.

Type
Articles
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2000

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References

1.Wood, AJ, Goodwin, GM. A review of the biochemical and neurop-harmacological actions of lithium. Psychol Med 1987:17:579600.CrossRefGoogle ScholarPubMed
2.McCance, SL. Cohen, PR, Cowen, PJ. Lithium increases 5-HT-media-ted prolactin release. Psychopharmacol 1989;99:276281.CrossRefGoogle ScholarPubMed
3.Cowen, PJ. McCance, SL. Ware, CJ. Cohen, PR. Chalmers, JS. Julier, DL. Lithium in tricyclic-resistanl depression. Correlation of increased brain 5-HT function with clinical outcome. Br J Psychiatry 1991:159:341346.CrossRefGoogle ScholarPubMed
4.Goodwin, FK, Ghaemi, SN. Understanding manic-depressive illness. Arch Gen Psychiatry 1998;55:2325.CrossRefGoogle ScholarPubMed
5.Reilly, JG. McTavish, SFB, Young, AH. Rapid depletion of plasma tryptophan: A review of studies and experimental methodology. J Psychopharmacol 1997; 11:381392.CrossRefGoogle ScholarPubMed
6.Katayama, J, Polich, J. Auditory and visual P300 topography from a 3 stimulus paradigm. Clin Neurophysiol 1999:110:463468.CrossRefGoogle ScholarPubMed
7.Benkelfat, C, Seletti, B, Palmour, RM, Hillel, J. Ellenbogen, M. Young, SN. Tryptophan depletion in stable lithium-treated patients with bipolar disorder in remission. Arch Gen Psychiatry 1995:52:154156.CrossRefGoogle ScholarPubMed
8.Smith, KA. Fairburn, CG, Cowen, PJ. Relapse of depression after rapid depletion of tryptophan. Lancet 1997:349(9056):915919.CrossRefGoogle ScholarPubMed
9.Tondo, L. Baldessarini, RJ. Floris, G. Rudas, N. Effectiveness of restarting lithium treatment after its discontinuation in bipolar I and bipolar II disorders. Am J Psychiatry. 1997:154:548550.Google ScholarPubMed
10.Tondo, L. Jamison, KR. Baldessarini, RJ. Effect of lithium maintenance on suicidal behavior in major mood disorders. Ann NY Acad Sci 1997:836:339351.CrossRefGoogle ScholarPubMed
11.Thies-Flechtner, K. Muller-Ocrlinghausen, B, Scibert, W. Walther, A. Greil, W. Effect of prophylactic treatment on suicide risk in patients with major affective disorders: data from a randomized prospective trial. Pharmacopsychiatry 1996:29:103107.CrossRefGoogle ScholarPubMed
12.Ferrier, IN. Perrv, EK. Post-mortem studies in affective disorder. Psychol Med 1992:22:835838.CrossRefGoogle ScholarPubMed
13.El Badri, SM. Ashton, CH, Ferrier, IN. McAllister, VA. Moore, PB. Neurobiological changes in young patients with bipolar affective disorder. J Psychopharmacol 1997:11 (Suppl):116.Google Scholar
14.Muir, WJ. St Clair, DM. Blackwood, DR. Long-latency auditory event-related potentials in schizophrenia and in bipolar and unipolar affective disorder. Psychol Med 1991:21:867879.CrossRefGoogle ScholarPubMed
15.Souza, VB. Muir, W.J., Walker, MT. Glabus, MF. Roxborough, HM. Sharp, CW, Dunau, JR. Blackwood, DH. Auditory P300 event-related potentials and neuropsychological performance in schizophrenia and bipolar affective disorder. Biol Psychiatry 1995:37:300310.CrossRefGoogle ScholarPubMed