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A Tale of 3 Cities, the Maastricht Masters & the Tryptophan Depletion story Professor Sean Hood Consultant Psychiatrist University of Western Australia.

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Presentation on theme: "A Tale of 3 Cities, the Maastricht Masters & the Tryptophan Depletion story Professor Sean Hood Consultant Psychiatrist University of Western Australia."— Presentation transcript:

1 A Tale of 3 Cities, the Maastricht Masters & the Tryptophan Depletion story Professor Sean Hood Consultant Psychiatrist University of Western Australia Perth, Australia

2 Servier + Pfizer Support

3 City # 1: Bristol

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5 Tryptophan Depletion in Social Anxiety Disorder. Dr Sean Hood Presented at The European Certificate in Anxiety and Mood Disorders, Santa Margherita Ligure, 2000

6 Tryptophan Depletion: Serotonin & Anxiety Study Protocol Overview Recruitment Patient fails to respond to standard open treatment (by CGI-I score): Routine outpatient care Exclusion Criteria met: Routine outpatient care Post-Study Follow-up Screening Day Exclusion Criteria met: Routine outpatient care Day 1Day 2 Standard open treatment 3/12 + SSRI

7 Tryptophan Depletion: Serotonin & Anxiety SAnD TD: Protocol Amino acid drink TRP Levels TRP Levels TRP Levels Time (hrs) TRP Levels #3: Neutral Script #2: Verbal Task #1: Autobiographical Script (fasting) Qu. +2 hrQu. +4 hr

8 Subjects:n=14 SSRI-remitted SAnD (CGI 1 or 2) Challenge:Autobiog. Script, Verbal Task, N. task Measures : SSAI,VAS,LSAS,SPIN CVS

9 Subjects:n=14 SSRI-remitted SAnD (CGI 1 or 2) Challenge:Autobiog. Script, Verbal Task, N. task Measures : SSAI,VAS,LSAS,SPIN CVS Results: ATD

10 Subjects:n=14 SSRI-remitted SAnD (CGI 1 or 2) Challenge:Autobiog. Script, Verbal Task, N. task Measures : SSAI,VAS,LSAS,SPIN CVS Results: ATD Challenge ATD x Challenge Psychological Physiological

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13 City # 2: Maastricht

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17 2004 Summer Conference of the British Association for Psychopharmacology. Harrogate, UK.

18 Acute Tryptophan Depletion in 5 clinical anxiety disorders: PD, SAnD, PTSD, GAD & OCD Neurotalk June 27 th, 2010 Singapore Professor Sean Hood Consultant Psychiatrist University of Western Australia Perth, Australia

19 5 Clinical Anxiety Disorders

20 Acute Tryptophan Depletion: Serotonin & Anxiety Acutely Depleting Serotonin Sx –(SSRI-remitted Depression) –SSRI-remitted SAnD (Social Anxiety) –SSRI-remitted PD (Panic) –CBT-remitted PD (Panic) –SSRI-remitted PTSD Acutely Depleting Serotonin NO Sx –SSRI-remitted GAD (Generalised Anxiety) –SSRI-remitted OCD (Obsessive Compulsive)

21 ATD in Anxiety Summary

22 City # 3: Perth

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25 Serotonin – HPA

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27 Serotonin – HPA 2

28 5HT & Hypertension & Stress (N) Volunteer Studies completed StudyATD35% CO2SSRI Completed Pre-1: ATD Vols (Shufflebotham et al. 2006) Pre-2: CO2 Vols (Shufflebotham et al. 2009) Pre-3: ATD CO2 Vols (Hood et al. 2006) Pre-4: ATD CO2 SSRI Vols (Hince et al. 2010) (3 weeks)

29 5HT & Hypertension & Stress (N) Volunteer Studies over Past 5 Years Significant Outcome Measures for Normal Volunteers StudyPsychologicalCardiovascularEndocrine Pre-1: ATD Vols (Shufflebotham, Hood, Hendry, Hince, Morris, Nutt, Probert, & Potokar 2006) Nil: ATD - Pre-2: CO2 Vols (Shufflebotham, Wetherell, Hince, Hood, Lightman, Nutt, Probert, & Potokar 2009) CO2 anxietyCO2 BPCO2 Cortisol Pre-3: ATD CO2 Vols (Hood, Hince, Robinson, Cirillo, Christmas, & Kaye 2006) Nil: ATD CO2 anxiety Nil: ATD x CO2 ATD BP (trend) CO2 BP Nil: ATD x CO2 ATD Cortisol CO2 Cortisol Nil: ATD x CO2 Pre-4: ATD CO2 SSRI Vols (Hince, Menon, Shadianloo, & Hood 2010) Nil: ATD CO2 anxiety Nil: 3 wk SSRI Nil: ATD x CO2 Nil: ATD x 3 wk SSRI CO2 x 3 wk SSRI anxiety Nil: ATD CO2 BP Nil: 3 wk SSRI Nil: ATD x CO2 Nil: ATD x 3 wk SSRI Nil: CO2 x 3 wk SSRI -

30 5HT & Hypertension & Stress (N) Volunteer Studies completed & proposed StudyATD35% CO2SSRI Completed Pre-1: ATD Vols (Shufflebotham et al. 2006) Pre-2: CO2 Vols (Shufflebotham et al. 2009) Pre-3: ATD CO2 Vols (Hood et al. 2006) Pre-4: ATD CO2 SSRI Vols (Hince et al. 2010) (3 weeks) Proposed Study 1: CO2 single dose SSRI (single dose) Study 2: ATD CO2 single dose SSRI (single dose)

31 Serotonin – Cardiovascular

32 5HT & Hypertension & Stress Davies, Hood et al. J Clin Psychopharm.

33 P & H: Autonomic Dysfunction

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35 Networking

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41 P & H: Autonomic Dysfunction

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45 From Rags to Riches in 10 years: How the Maastricht Masters made me fantastically successful. Professor Sean Hood Consultant Psychiatrist University of Western Australia Perth, Australia


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