No effects of acute tryptophan depletion on anxiety or mood in weight-recovered female patients with anorexia nervosa

Tomas Weinert^#¹, Fabio Bernardoni^#¹, Joseph King¹, Julius Steding¹, Ilka Boehm¹, Merle Mannigel¹, Franziska Ritschel¹, Florian Zepf^{2

3

4}, Veit Roessner⁵, Stefan Ehrlich^{6

7}

Affiliations

¹ Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
² Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia.
³ Telethon Kids Institute, Perth, WA, Australia.
⁴ Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
⁵ Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
⁶ Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany. transden.lab@uniklinikum-dresden.de.
⁷ Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. transden.lab@uniklinikum-dresden.de.

^# Contributed equally.

PMID: 35511296
PMCID: PMC9957824
DOI: 10.1007/s00406-022-01414-8

Randomized Controlled Trial

No effects of acute tryptophan depletion on anxiety or mood in weight-recovered female patients with anorexia nervosa

Tomas Weinert et al. Eur Arch Psychiatry Clin Neurosci. 2023 Feb.

. 2023 Feb;273(1):209-217.

doi: 10.1007/s00406-022-01414-8. Epub 2022 May 5.

Authors

Tomas Weinert^#¹, Fabio Bernardoni^#¹, Joseph King¹, Julius Steding¹, Ilka Boehm¹, Merle Mannigel¹, Franziska Ritschel¹, Florian Zepf^{2

3

4}, Veit Roessner⁵, Stefan Ehrlich^{6

7}

Affiliations

¹ Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
² Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia.
³ Telethon Kids Institute, Perth, WA, Australia.
⁴ Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
⁵ Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
⁶ Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany. transden.lab@uniklinikum-dresden.de.
⁷ Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. transden.lab@uniklinikum-dresden.de.

^# Contributed equally.

PMID: 35511296
PMCID: PMC9957824
DOI: 10.1007/s00406-022-01414-8

Abstract

Background: Previous studies have suggested that individuals recovered from anorexia nervosa (AN) are characterized by increased serotonergic (5-HT) activity that might be related to elevated levels of anxiety. Assuming these traits to be also present in individuals at risk for AN, it was further hypothesized that restricting food intake might be a means to temporarily alleviate dysphoric affective states by reducing central nervous availability of tryptophan (TRP), the sole precursor of 5-HT. One study that supported this hypothesis found anxiolytic effects in individuals with a history of AN during an experimentally induced short-term depletion of TRP supply to the brain.

Methods: In this placebo-controlled, double-blind cross-over study, 22 patients weight-recovered from AN (recAN) and 25 healthy control participants (HC) completed questionnaires assessing anxiety and momentary mood during acute tryptophan depletion (ATD), a dietary intervention that lowers central 5-HT synthesis.

Results: The ATD procedure effectively reduced the ratio of TRP to competing for large neutral amino acids in the peripheral blood, indicating decreased TRP supply to the brain. Effects of ATD on anxiety and mood did not differ between recAN and HC. Bayesian null hypothesis testing confirmed these initial results.

Discussion: Our results do not support the hypothesis that short-term depletion of TRP and its impact on the brain 5-HT reduces anxiety or improves mood in AN. As the evidence for the role of 5-HT dysfunction on affective processes in patients with AN is limited, further studies are needed to assess its relevance in the pathophysiology of AN.

Keywords: Anorexia nervosa; Anxiety; Eating disorders; Serotonin; Tryptophan.

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Conflict of interest statement

V. Roessner has received payment for consulting and writing activities from Lilly, Novartis, and Shire Pharmaceuticals; lecture honoraria from Lilly, Novartis, Shire Pharmaceuticals, and Medice Pharma; and support for research from Shire and Novartis. He has carried out (and is currently carrying out) clinical trials in cooperation with Novartis, Shire, and Otsuka. The other authors declare that there is no conflict of interest.

References

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No effects of acute tryptophan depletion on anxiety or mood in weight-recovered female patients with anorexia nervosa

Affiliations

No effects of acute tryptophan depletion on anxiety or mood in weight-recovered female patients with anorexia nervosa

Authors

Affiliations

Abstract

Conflict of interest statement

References

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