A Tale of 3 Cities, the Maastricht Masters & the Tryptophan Depletion story Professor Sean Hood

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

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 Patient fails to respond to standard open treatment (by CGI-I score): Routine outpatient care Exclusion Criteria met: Routine outpatient care Exclusion Criteria met: Routine outpatient care Screening Day Standard open treatment3/12+ SSRI Day 1 Day 2 Post-Study Follow-up Recruitment

7. Tryptophan Depletion: Serotonin & Anxiety SAnD TD: Protocol #1: Autobiographical Script #2:VerbalTask #3:NeutralScript Amino acid drink Qu. +2 hr Qu. +4 hr (fasting) Time (hrs) 0 +1 +2 +3 +4 +5 +6 +7 TRP Levels TRP Levels TRP Levels TRP Levels

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

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

10. Subjects:n=14 SSRI-remittedSAnD (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

13. City # 2: Maastricht

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 27th, 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

25. Serotonin – HPA

26. Serotonin – HPA

27. 5HT & Hypertension & Stress(N) Volunteer Studies completed

28. 5HT & Hypertension & Stress(N) Volunteer Studies over Past 5 Years

29. Serotonin – Cardiovascular

30. 5HT & Hypertension & StressDavies, Hood et al. J Clin Psychopharm.

31. P & H: Autonomic Dysfunction

32. P & H: Autonomic Dysfunction

33. Networking

39. P & H: Autonomic Dysfunction

43. 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