Evaluation of the combination of tryptophan and ECT in the treatment of depression

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Abstract
A double‐blind evaluation of the antidepressant efficacy of treatment with a combination of orally administered L‐tryptophan (L‐TP) and electroconvulsive therapy (ECT) was made in patients suffering from endogenous depression. The patients were randomly assigned to two groups, one treated with L‐TP (6 g daily) and unilateral ECT, the other with placebo and unilateral ECT. L‐TP treatment was initiated at least 1 day before the first ECT and terminated 4 days after the last ECT.There was a good agreement between the two groups in several measures of antidepressant efficacy: doctors' and patients' ratings of depressive symptoms, and doctors' global rating of therapeutic effect 4 days and 1 month after the last ECT. In the L‐TP group, however, there was a significantly better effect on retardation symptoms in the nurses' rating scale. This difference, which is not consistent with other measures of amelioration, contributes, at most, to a marginal therapeutic addition to the antidepressant effect of ECT. It is concluded that oral administration of L‐TP, in the dose of 6 g daily, is not of practical value for potentiating the antidepressant efficacy of ECT.

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