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The treatment of depression with L-5-Hydroxytryptophan versus imipramine

Results of two open and one double-blind study

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Summary

In the last few years several open studies supported the hypothesis that L-5-HTP may be an effective antidepressant. Because of the lack of a controlled double-blind trial we started our own investigations to confirm this hypothesis in L-5-HTP. In 1972 we performed two open dose finding trials with L-5-HTP in combination with Benzerazide. These open studies were followed by a double-blind trial comparing L-5-HTP in combination with Benzerazide to Imipramine in 30 patients. Assessments were carried out on day 0, 5, 10, 15 and 20.

For data collection we used the Hamilton Rating Scale for Depression, the AMP-system, a Global Rating Scale of Severity of Depression and a Brief Rating Scale for the Behaviour on the ward. In this article we report only a part of the results, mainly on the findings with the AMP-system and the Hamilton Rating Scale for Depression.

During our double-blind trial we could not find any significant difference in efficacy of L-5-HTP and Imipramine. The same was found in an open trial. Furthermore the L-5-HTP results showed no difference compared with the results of an Imipramine treatment in 40 patients in earlier double-blind studies.

L-5-HTP and Imipramine caused different patterns of side effects. L-5-HTP caused mainly gastrointestinal side effects and Imipramine caused mainly dryness of the mouth and tremor. The gastrointestinal side effects caused by L-5-HTP seemed to be dose dependent.

Zusammenfassung

In den letzten Jahren ergaben verschiedene offene Prüfungen Hinweise für die Hypothesen, daß L-5-HTP ein wirksames Antidepressivum sei. Weil kontrollierte doppelblinde Prüfungen fehlten, begannen wir eigene Untersuchungen, um diese Hypothese zu überprüfen. Im Jahre 1972 führten wir 2 offene Studien mit L-5-HTP, in Kombination mit Benzerazid durch. Diesen beiden offenen Prüfungen folgte eine Doppelblindstudie in der wir L-5-HTP in Kombination mit Benzerazid gegen Imipramin an 30 Patienten prüften. Die Untersuchungen der Patienten wurden an den Tagen 0, 5, 10, 15 und 20 durchgeführt.

Für die Datensammlung benützten wir die Hamilton-Skala für Depressionen, das AMP-System, eine globale Rating-Skala des Schweregrades der Depression und eine Rating-Skala des Verhaltens auf den Abteilungen. In diesem Artikel führen wir nur einen Teil der Resultate auf, vor allem solche, die mit dem AMP-System und der Hamilton-Skala für Depressionen gewonnen wurden.

Die Doppelblindprüfung ergibt keine signifikanten Wirkungsunterschiede zwischen L-5-HTP und Imipramin; das gleiche gilt für eine offene Prüfung. Die L-5-HTP Resultate zeigten ferner keinen Unterschied zu den Ergebnissen von Imipraminbehandlungen an 40 Patienten aus früheren doppelblinden Prüfungen.

L-5-HTP und Imipramin verursachten verschiedene Arten von Nebenwirkungen, L-5-HTP vor allem gastrointestinale Nebenwirkungen und Imipramin vor allem Mundtrockenheit und Tremor. Die gastrointestinalen Nebenwirkungen bei L-5-HTP scheinen dosisabhängig zu sein.

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  1. Psychiatric University Clinic Zurich, Switzerland

    J. Angst, B. Woggon & J. Schoepf

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  1. J. Angst
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  2. B. Woggon
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  3. J. Schoepf
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Angst, J., Woggon, B. & Schoepf, J. The treatment of depression with L-5-Hydroxytryptophan versus imipramine. Arch. Psychiat. Nervenkr. 224, 175–186 (1977). https://doi.org/10.1007/BF00346485

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