Graphical abstract Excessive dieting‐induced nutritional deficiency of tryptophan : Effects on behavior and efficacy of antipsychotic and antidepressant medication .
& NA ; A growing body of evidence suggests that our diet is an important contributing factor in the development , management and prevention of a number of psychiatric illnesses .
Tryptophan , an essential amino acid , is the sole precursor of neurotransmitter 5‐hydroxytryptamine ( 5‐HT ; serotonin ) .
Administration of tryptophan can boost serotonin neurotransmission to produce therapeutically important effects in serotonin deficiency disorders .
Anorexia nervosa ( AN ) an eating disorder associated with high levels of psychiatric comorbidity including psychosis , hyperactivity , depression and anxiety has highest lethality of all psychiatric illnesses .
Evidence suggests that excessive dieting and food restriction can decrease brain tryptophan and serotonin in AN patients to precipitate depression , psychosis and hyperactivity .
There are currently no FDA approved pharmacological treatments available for AN patients ; antidepressants and antipsychotics , largely used to treat associated psychiatric comorbidities are also not very effective .
The aim of this non‐ systematic review article is to evaluate and document a potential importance of tryptophan supplementation in improving therapeutics in AN patients .
Fluoxetine after weight restoration in anorexia nervosa: a randomized controlled trial.
CONTEXT Antidepressant medication is frequently prescribed for patients with anorexia nervosa . OBJECTIVE To determine whether fluoxetine can promote recovery and prolong time-to-relapse among patients with anorexia nervosa following weight restoration . DESIGN , SETTING , AND PARTICIPANTS R and omized , double-blind , placebo-controlled trial . From January 2000 until May 2005 , 93 patients with anorexia nervosa received intensive inpatient or day-program treatment at the New York State Psychiatric Institute or Toronto General Hospital . Participants regained weight to a minimum body mass index ( calculated as weight in kilograms divided by the square of height in meters ) of 19.0 and were then eligible to participate in the r and omized phase of the trial . INTERVENTIONS Participants were r and omly assigned to receive fluoxetine or placebo and were treated for up to 1 year as out patients in double-blind fashion . All patients also received individual cognitive behavioral therapy . MAIN OUTCOME MEASURES The primary outcome measures were time-to-relapse and the proportion of patients successfully completing 1 year of treatment . RESULTS Forty-nine patients were assigned to fluoxetine and 44 to  placebo . Similar percentages of patients assigned to fluoxetine and to placebo  maintained a body mass index of at least 18.5 and remained in the study for 52 weeks ( fluoxetine , 26.5 % ; placebo , 31.5 % ; P = .57 ) . In a Cox proportional hazards analysis , with prer and omization body mass index , site , and diagnostic subtype as covariates , there was no significant difference between fluoxetine and placebo in time-to-relapse ( hazard ratio , 1.12 ; 95 % CI , 0.65 - 2.01 ; P = .64 ) . CONCLUSIONS This study failed to demonstrate any benefit from fluoxetine in the treatment of patients with anorexia nervosa following weight restoration . Future efforts should focus on developing new models to underst and the persistence of this illness and on exploring new psychological and pharmacological treatment approaches . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00288574
Graphical abstract Excessive dieting‐induced nutritional deficiency of tryptophan : Effects on behavior and efficacy of antipsychotic and antidepressant medication .
& NA ; A growing body of evidence suggests that our diet is an important contributing factor in the development , management and prevention of a number of psychiatric illnesses .
Tryptophan , an essential amino acid , is the sole precursor of neurotransmitter 5‐hydroxytryptamine ( 5‐HT ; serotonin ) .
Administration of tryptophan can boost serotonin neurotransmission to produce therapeutically important effects in serotonin deficiency disorders .
Anorexia nervosa ( AN ) an eating disorder associated with high levels of psychiatric comorbidity including psychosis , hyperactivity , depression and anxiety has highest lethality of all psychiatric illnesses .
Evidence suggests that excessive dieting and food restriction can decrease brain tryptophan and serotonin in AN patients to precipitate depression , psychosis and hyperactivity .
There are currently no FDA approved pharmacological treatments available for AN patients ; antidepressants and antipsychotics , largely used to treat associated psychiatric comorbidities are also not very effective .
The aim of this non‐ systematic review article is to evaluate and document a potential importance of tryptophan supplementation in improving therapeutics in AN patients .