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Nutrient imbalances in depressive disorders. Possible brain mechanisms
R J Wurtman1, D O'Rourke, J J Wurtman
1Clinical Research Center, Massachusetts Institute of Technology, Cambridge 02139.
Annals of the New York Academy of Sciences
|January 1, 1989
Summary
D-fenfluramine, a serotonin-releasing drug, effectively treated seasonal affective disorder (SAD) symptoms, including carbohydrate craving and depression. This study suggests serotonin plays a key role in SAD
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Seasonal Affective Disorder (SAD) is a variant of depression linked to hyperphagia and carbohydrate craving.
- D-fenfluramine is a serotonin-releasing agent known to reduce carbohydrate craving and weight gain in obese individuals.
Purpose of the Study:
- To evaluate the efficacy of d-fenfluramine in treating patients with Seasonal Affective Disorder (SAD).
- To investigate the role of serotonin in the affective and appetitive symptoms of SAD.
Main Methods:
- A double-blind, placebo-controlled study involving 18 patients with SAD.
- Patients received either d-fenfluramine (15 mg twice daily) or placebo for four weeks, with a two-week washout period.
- SAD symptoms were assessed using clinical interviews and the Hamilton Depression Rating Scale (HDS) with a SAD addendum (ADD).
Main Results:
- D-fenfluramine treatment led to significant reductions in HDS scores (71% decrease) and ADD scores (73% decrease) compared to placebo.
- 72% of subjects showed a complete reversal of abnormal test scores with d-fenfluramine.
- Patients on d-fenfluramine experienced a mean weight loss of 1.2 kg.
Conclusions:
- D-fenfluramine demonstrates potential as an effective treatment for SAD, addressing both mood and appetite symptoms.
- The findings support the involvement of serotonin in the pathophysiology of SAD.
- Carbohydrate craving in SAD patients may be linked to the psychotropic effects of serotonin.