Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-18T23:27:39.707Z Has data issue: false hasContentIssue false
  • English
  • Français

The neuroendocrine responses and psychological effects of infusion of L-tryptophan in anorexia nervosa

Published online by Cambridge University Press:  09 July 2009

G. M. Goodwin ,
C. M. Shapiro ,
J. Bennie ,
H. Dick ,
S. Carroll  and
G. Fink
G. M. Goodwin*
Affiliation:
MRC Brain Metabolism Unit and University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh
C. M. Shapiro
Affiliation:
MRC Brain Metabolism Unit and University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh
J. Bennie
Affiliation:
MRC Brain Metabolism Unit and University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh
H. Dick
Affiliation:
MRC Brain Metabolism Unit and University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh
S. Carroll
Affiliation:
MRC Brain Metabolism Unit and University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh
G. Fink
Affiliation:
MRC Brain Metabolism Unit and University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh
*
1Address for correspondence: Dr G. M. Goodwin, MRC Brain Melabohsm Unit. University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park. Edinburgh EH 10 5HF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The secretion of prolactin and growth hormone (GH), together with subjective ratings of sedation and hunger, were determined in 13 in-patients with anorexia nervosa and 15 controls during the intravenous infusion of L-tryptophan (100 mg/kg). Prolactin responses were not different between groups but GH responses were markedly blunted in patients. In addition sedation responses in patients were attenuated compared with controls. Hunger ratings were reduced by the infusion in controls but were too variable to be interpreted in the patients. Plasma amino acid levels were also determined before and after infusion of L-tryptophan. Tryptophan levels were comparable in the two groups as were the levels of tyrosine, phenyl alanine, valine, leucine and iso-leucine. The results suggest that some aspects of 5-hydroxytryptamine function may be attenuated in anorexia nervosa. However, they undoubtedly contrast with the finding of enhanced hormonal responses in acute dieting and may be relevant to the interpretation of similar experiments in depressive illness.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 4 , November 1989 , pp. 857 - 864
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. E. & Erbaugh, J. K. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–561.Google Scholar
Blundell, J. E. (1984). Serotonin and appetite Neuropharmacology 23, 1537–1537.Google Scholar
Brown, G. M., Garfinkel, P. E., Jeuniewic, N., Moldofsy, H. & Stancer, H. C. (1977). Endocrine profiles in anorexia nervosa. In Anorexia Nervosa (ed. Vigersky, R. A.), pp. 123–125. Raven Press: New York.Google Scholar
Casper, R. C., Davis, J. M. & Pandey, G. N. (1977). The effects of the nutritional status and weight changes on hypothalamic function tests in anorexia nervosa. In Anorexia Nervosa (ed Vigersky, R. A.), pp. 137–148. Raven Press: New York.Google Scholar
Charney, D. S., Heninger, G. R., Reinhard, J. F., Sternberg, G. E. & Hafstead, K. M. (1982). The effect of intravenous L-tryptophan on prolactin and growth hormone and mood in healthy subjects. Psychopharmacology 77, 217–217.Google Scholar
Coppen, A. J., Gupta, R. K., Eccleston, E. G., Wood, K., Wakeling, A. & de Souza, V F. A. (1976). Plasma tryptophan in anorexia nervosa. Lancet 1, 961.Google Scholar
Cowen, P. J. (1987). Psychotropic drugs and human 5–HT neuroendocrinology. Trends in Pharmacological Sciences 8, 105–105.Google Scholar
Cowen, P. J. & Charig, E. (1987). Neuroendocrine responses to intravenous tryptophan in major depression. Archives of General Psychiatry 44, 958–958.Google Scholar
Cowen, P J., Gadhvi, H, Gosden, B. & Kolakowska, T (1985). Responses of prolactin and growth hormone to l-tryptophan infusion: effects in normal subjects and schizophrenic patients receiving neuroleptics. Psychopharmacology 86, 164–164.Google Scholar
De Marinis, L., Folli, G., D'Amico, C., Mancini, A., Sambo, P., Tofani, A., Oradei, A. & Barbarino, A. (1988). Differential effects of feeding on the ultradian variation of the growth hormone (GH) response to GH-Releasing Hormone in normal subjects and patients with obesity and anorexia nervosa. Journal of Clinical Endocrinology and Metabolism 66, 598–598.Google Scholar
Ettigi, P.Lai, S, Martin, J. & Friesen, H. G. (1975). Effects of sex, oral contraceptive and glucose loading on apomorphine-induced growth hormone secretion. Journal of Clinical Endocrinology and Metabolism 40, 1094–1094.Google Scholar
Fichter, M. M. & Pirke, K. M. (1986). Effect of experimental and pathological weight loss upon the hypothalamo-pituitary-adrenal axis. Psychoneuroendocrinology 3, 295–295.Google Scholar
Garner, D. M. & Garfinkel, P. E. (1979) The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine 9, 273–273.Google Scholar
Gershon, E. S., Schreiber, J. L., Hamovit, J. R., Dibble, E. D., Kaye, W., Numberger, J. I., Andersen, A. E. & Ebert, M. (1984). Clinical findings in patients with anorexia nervosa and affective illness in their relatives. American Journal of Psychiatry 141, 1419–1419.Google Scholar
Gillman, P. J., Bartlelt, J. R., Bridges, P. K., Hunt, A., Patel, A. J., Kantamaneni, B. D & Curzon, G. (1981). Indolic substances in plasma, cerebrospinal fluid and frontal cortex of human subjects infused with saline or tryptophan. Journal of Neurochemistry 37, 410–410.Google Scholar
Goodwin, G. M., Fairburn, C. G. & Cowen, P. J. (1987 a). Dieting changes serotonergic function in women, not men: implications for the aetiology of anorexia nervosa. Psychological Medicine 17, 839–839.Google Scholar
Goodwin, G. M., Fairburn, C. G. & Cowen, P. J. (1987 b) The effects of dieting and weight loss on neuroendocrine responses to tryptophan, clonidine and apomorphine in volunteers. Archives of General Psychiatry 44, 952–952.Google Scholar
Kaye, W. H., Ebert, M. H., Raleigh, M & Lake, C. R. (1984). Abnormalities in CNS monoamine metabolism in anorexia nervosa. Archives of General Psychiatry 41, 350–350.Google Scholar
Maclndoe, J. H. & Turkington, R. W. (1973). Stimulation of prolactin secretion by intravenous L-tryptophan. Journal of Clinical Investigation 52, 1972–1972.Google Scholar
Pahl, J., Pirke, K. M., Schweiger, U., Warnhoff, M., Gerlinghoff, M., Brinkmann, W., Berger, M. & Krieg, Ch. (1985). Anorectic behaviour, mood, and metabolic and endocrine adaptation to starvation in anorexia nervosa during inpatient treatment. Biological Psychiatry 20, 874–874.Google Scholar
Russell, G. F. M. (1970). Anorexia nervosa: its identity as an illness and its treatment. In Modern Trends in Psychological Medicine, Vol. II (ed. Harding, J.), pp. 131–164. Butterworth: London.Google Scholar
Sherman, B. M. & Halmi, K. A. (1977). Effect of nutritional rehabilitation on hypothalamic-pituitary function in anorexia nervosa. In Anorexia nervosa (ed. Vigersky, R. A.), pp. 211–224. Raven Press: New YorkGoogle Scholar
Silverstone, T. (1983). The clinical pharmacology of appetite – its relevance to psychiatry. Psychological Medicine 13, 251–251.Google Scholar
Trulson, M. E. & Himmel, C. D. (1983). Decreased brain dopamine synthesis rate and increased [3H] spiroperidol binding in streptozotocin-diabetic rats. Journal of Neurochemisiry 40, 1456–1456.CrossRefGoogle ScholarPubMed
Turnell, D. C. & Cooper, J. D. H. (1982). Rapid assay for amino acids in serum or urine by pre-column derivatization and reversedphase liquid chromatography. Clinical Chemistry 28, 527–527.Google Scholar
Wakeling, A., De Souza, V. F. A., Gore, M. B. R., Sabur, M., Kingstone, D. & Boss, A. M. B. (1979). Amenorrhoea, body eight and serum hormone concentrations, with particular reference to prolactin and thyroid hormones in anorexia nervosa. Psychological Medicine 9, 265–265.Google Scholar
Wurtman, R. J., Hefti, F. & Melamed, E. (1981). Precursor control of transmitter synthesis. Pharmacological Reviews 32, 315–335Google Scholar
Waldhauser, F., Toifl, K., Spona, J., Zeitlhuber, U., Waldhauser, M. & Frisch, H. (1984). Diminished prolactin response to thyrotropin and insulin in anorexia nervosa. Journal of Clinical Endocrinology and Metabolism 59, 583–583.Google Scholar