Effects of rapid tryptophan depletion on mood and urge to drink in patients with co-morbid major depression and alcohol dependence

Pierucci‐Lagha, Amira; Feinn, Richard; Modesto‐Lowe, Vania; Swift, Robert M.; Nellissery, Maggie; Covault, Jonathan; Kranzler, Henry R.

doi:10.1007/s00213-003-1588-6

Cited by 21 publications

(15 citation statements)

References 74 publications

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“…16 Further, during rapid tryptophan depletion in depressed alcoholics who responded to treatment with serotonergic antidepressants, L-allele homozygotes reported greater depression than S-allele carriers. 23 This replicated findings from an earlier report in depressed non-alcoholics. 24 …”

Section: Introductionsupporting

confidence: 88%

A Double-Blind, Randomized Trial of Sertraline for Alcohol Dependence

Kranzler¹,

Armeli²,

Tennen³

et al. 2011

Journal of Clinical Psychopharmacology

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Late-onset/low vulnerability alcoholics (LOAs) appear to drink less when treated with an SSRI than placebo, whereas early-onset/high vulnerability alcoholics (EOAs) show the opposite effect. We conducted a 12-week, parallel-groups, placebo-controlled trial of the efficacy of sertraline in alcohol dependence (AD). We compared the effects in LOAs vs. EOAs and examined the moderating effects of a functional polymorphism in the serotonin transporter gene. Patients (N=134; 80.6% male; 34.3% EOAs) with DSM-IV AD received up to 200 mg of sertraline (N=63) or placebo (N=71) daily. We used urn randomization and patients were genotyped for the tri-allelic 5-HTTLPR polymorphism. Planned analyses included main and interaction effects of Medication Group, Age of Onset (≤25 years vs. >25 years), and Genotype (L′/L′ vs. S’carriers) on drinking outcomes. Results showed that the moderating effect of Age of Onset on the response to sertraline was conditional on Genotype. There were no main or interaction effects among S′ allele carriers. However, in L′ homozygotes, the effects of Medication Group varied by Age of Onset (P=0.002). At the end of treatment, LOAs reported fewer drinking and heavy drinking days when treated with sertraline (P=0.011), while EOAs had fewer drinking and heavy drinking days when treated with placebo (P<0.001). The small cell sizes and high rate of attrition, particularly for L′ homozygotes, render these findings preliminary and their replication in larger samples necessary. Because AD is common, particularly in medical settings, and SSRIs are widely prescribed by practitioners, these findings have potential public health significance and warrant further evaluation.

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Section: Introductionsupporting

confidence: 88%

A Double-Blind, Randomized Trial of Sertraline for Alcohol Dependence

Kranzler¹,

Armeli²,

Tennen³

et al. 2011

Journal of Clinical Psychopharmacology

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“…Cocaine use depletes monoamines and serotonin, and dietary depletion of serotonin of these neurotransmitters is associated with reversible worsening of depressive symptoms among individuals with mood disorders. Of particular interest, dietary serotonin depletion of serotonin has been shown to increase both depressive symptoms and craving among alcoholics with major depression (Pierucci-Lagha A 2006). Chronic cocaine use has also been associated with deficits in attention, memory, and executive functioning ) that are components of the ADHD syndrome, as well as abnormalities in blood flow and metabolism in the brain regions subserving these functions (Goldstein et al 2004;Volkow et al 1991;Woods et al 1991).…”

Section: Effect Of Co-occurring Disorders On Cocaine Usementioning

confidence: 99%

Effects of major depressive disorder and attention-deficit/hyperactivity disorder on the outcome of treatment for cocaine dependence

Levin¹,

Bisaga²,

Raby³

et al. 2008

Journal of Substance Abuse Treatment

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Co-occurring psychiatric disorders have been associated with poor prognosis among substance dependent patients, but few studies have examined this association among patients with cocaine dependence (CD). Baseline characteristics and treatment outcome were compared between cocainedependent patients with major depression (MDD) (N = 66), attention-deficit/hyperactivity disorder (ADHD) (N = 53), or cocaine dependence without comorbid disorders (CD alone) (N = 48), who had been randomized to the placebo arms of clinical trials of venlafaxine, methylphenidate, and gabapentin, respectively. The three groups differed significantly in racial makeup, with more Caucasians and Hispanics among patients with MDD or ADHD, and more African Americans among those with CD alone. The groups did not differ significantly in treatment retention, with retention rates ranging from 42-47%, or in the rates of achieving 2 consecutive weeks of urine-confirmed abstinence, with rates ranging from 40-50%. Using logistic regression for repeated measures with general estimating equations, modeling the likelihood of a cocaine positive week over time in treatment, diagnostic group was found to interact with the baseline level of cocaine use and time. Among cocaine dependent patients who achieved abstinence at baseline, the groups with MDD or ADHD had better outcome over time than those with CD alone. However, among patients with cocaine positive urines at baseline, MDD or ADHD were associated with poor outcome compared to patients with CD alone. The findings suggest that diagnosis and treatment of co-occurring disorders such as depression and ADHD may be an important component of treatment planning for cocaine dependence, and that baseline level of cocaine use should be included as a covariate in studies evaluating the impact of such treatment.

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“…Results provide further human experimental evidence suggesting that serotonin is involved in the direct control of cigarette smoking behavior (Hitsman et al 2005), and also may play an important role in regulating cravingassociated processes. Tryptophan depletion has been previously shown to influence urge to drink alcohol among patients with alcohol dependence and MDD who had responded to serotonergic antidepressant treatment (Pierucci-Lagha et al 2004).…”

Section: Discussionmentioning

confidence: 99%