Table 3. Contrasting Clinical Effects of Serotonin Depletion



Subject	Clinical	Significant Increase in
Group	Status	Clinical Syndrome^a		Reference
		Yes	No
Healthy Subjects
	No Treatment		x	26
	Catecholamine Depletion		x	75
	Treated with SSRI for 3 weeks		x	5

Major Depression
	Depressed off Drugs		x	21
	Recently Recovered on SSRI	x^b		18,20
	Recently Recovered on CRI		x	20
	Recently Recovered with Sleep Deprivation		x	64
	Recently Recovered with ECT		x	12
	Remotely Recovered Currently not on Drugs	x^c		81

Seasonal Affective Disorder
	Depressed off Drugs		x	63
	Recently Recovered with Light Therapy	x		44,61,65
	Recently Recovered in Summer	x		62

Bulimic Nervosa
	Symptomatic off Drugs	x		89
	Recently Recovered off Drugs	x		66,80

OCD
	Symptomatic off Drugs		x	79
	Recently Improved on SSRI		x	4

a. Symptom increase is large enough to be of clinical significance.

b. 10 Male patients on SSRI with a long duration of remission did not show symptom increase (55).

c. One study did not find this (47).

CRI = Catecholamine Uptake Inhibitor.