Metabolic Brain Disease

, Volume 33, Issue 3, pp 647–660 | Cite as

The role of tryptophan metabolism in postpartum depression

  • Kai-Ming Duan
  • Jia-Hui Ma
  • Sai-Ying Wang
  • ZhengDong Huang
  • YingYong Zhou
  • HeYa Yu
Review Article


The Postpartum depression (PPD) is the most common postpartum psychiatric disorder, afflicting approximately 10%–20% of new mothers. Clinical symptoms of the PPD include depressive disorder, agitation, insomnia, anxiety and confusion, resulting in an increase in suicidal tendencies, thereby having significant impacts on the puerpera, newborn and their family. A growing body of data indicate a role for alterations in tryptophan metabolism in the PPD. The metabolism of tryptophan produces an array of crucial factors that can differentially regulate key physiological processes linked to the PPD. Importantly, an increase in stress hormones and immune-inflammatory activity drives tryptophan to the production of neuroregulatory kynurenine pathway products and away from the serotonin and melatonin pathways. This links the PPD to other disorders of depressed mood, which are classically associated with decreased serotonin and melatonin, coupled to increases in kynurenine pathway products. Several kynurenine pathway products, such as kynurenic acid and quinolinic acid, can have neuroregulatory effects, with consequences pathological underpinnings of the PPD. The current article reviews the role of alterations in tryptophan metabolism in the PPD.


Postpartum depression Tryptophan metabolism Serotonin pathway Kynurenine pathway 



This work was supported by the National Natural Science Foundation of China (81302852, 81573508).

Author Contributions

Authors Sai-Ying Wang and HeYa Yu managed the literature searches and analyses. Authors Jia-Hui Ma,ZhengDong Huang and YingYong Zhou undertook the statistical analysis, and author Kai-Ming Duan wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kai-Ming Duan
    • 1
  • Jia-Hui Ma
    • 1
  • Sai-Ying Wang
    • 1
    • 2
    • 3
    • 4
  • ZhengDong Huang
    • 1
  • YingYong Zhou
    • 1
  • HeYa Yu
    • 1
  1. 1.Department of AnesthesiologyThird Xiangya Hospital of Central South UniversityChangshaPeople’s Republic of China
  2. 2.Department of Clinical Pharmacology, Xiangya HospitalCentral South UniversityChangshaPeople’s Republic of China
  3. 3.Institute of Clinical PharmacologyCentral South University, Hunan Key Laboratory of PharmacogeneticsChangshaPeople’s Republic of China
  4. 4.Hunan Province Cooperation Innovation Center for Molecular Target New Drug StudyHengyangPeople’s Republic of China

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