Xanthurenic acid (XA) is a secondary product of the biosynthesis of nicotinamide from L-tryptophan. Disturbances in this pathway have been observed in depression. An enhanced glucocorticoid secretion is considered to induce this pathway. This could result in reduced levels of L-tryptophan (L-TRP) in
The clinical significance of disordered renal excretion of xanthurenic acid in depressive patients
β Scribed by M. J. A. J. M. Hoes; N. Sijben
- Publisher
- Springer
- Year
- 1981
- Tongue
- English
- Weight
- 458 KB
- Volume
- 75
- Category
- Article
- ISSN
- 0033-3158
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β¦ Synopsis
Xanthurenic acid is a metabolite of L-tryptophannicotinic acid ribonucleotide biosynthesis. The excretion of xanthurenic acid from urine 24 h after ingestion of 5 g L-tryptophan is increased in depressive patients, and 17-hydroxycorticosteroids are considered of primary importance to this disorder. However, in this study, the excretion of xanthurenic acid and 17-hydroxycorticosteroids did not correlate with the scores of the Raskin depression scale, Hamilton depression scale, Zung depression scale, or the Zung anxiety scale in depressive patients. The patients were treated with either pyridoxine plus L-tryptophan, a presumably serotoninenhancing treatment (n = 10) or maprotiline, a noradrenalinenhancing drug (n = 10). Repeated measurements showed no differences between treatments after 2 or 4 weeks of treatment. The improvement in xanthurenic acid excretion precedes clinical improvements in depression. The excretion of xanthurenic acid only at 2 weeks correlated significantly with the anxiety and depression scores at 4 weeks, making prediction of clinical improvement possible. The neurobiological mode of action on noradrenergic or serotonergic neurons of antidepressant medication is of questionable significance to their therapeutic effect.
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