By A.L & Schwartz, Morton Latner
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Only two important abnormalities encountered in users of oral contraceptives may be related to vitamin B, deficiency: severe depression and impairment of glucose tolerance. Although in the majority of oral contraceptive users the symptoms of a neuropsychiatric disorder may be rather trivial and short-lived, a small proportion of these women complain of severe depression which seems to be related to the use of the steroids. There are theoretical reasons for suggesting that the symptoms may be related to a defect in 5hydroxytryptamine production in the brain ( R U , W E ) .
GARTH WILSON AND RICHARD E. DAVIS what different pattern of excretion of tryptophan metabolites in patients taking isonicotinic acid hydrazide without vitamin B, supplements. Krishwaswamy (K12) observed that some patients with tuberculosis, undergoing therapy with isonicotinic acid hydrazide, varied in their sensitivity to the drug, even after accounting for the patients’ inherited capacity to inactivate it (slow/fast acetylation), H e loaded his patients with methionine and showed increased urinary excretion of cystathionine and an elevated ratio of cystathionine to cysteine sulfonic acid, suggesting a block in conversion of cystathionine to the cysteine sulfonic acid.
However, Reinken and Gant (R12) showed that women with significant vomiting in the first trimester of pregnancy had plasma pyridoxal levels significantly lower than those of age-matched nonpregnant women, or those of pregnant women in their first trimester who were not suffering significant morning sickness. The plasma pyridoxal levels in the affected group returned to normal after treatment with 100mg of oral pyridoxine for 7 days, and there was significant clinical improvement. Depressive illnesses in oral contraceptive users have been related to relative pyridoxal phosphate deficiency; therefore it is not surprising that postpartum depression should be considered from this point of view, assum- CLINICAL CHEMISTRY OF VITAMIN B6 33 ing that in some women the state of vitamin B, deficiency produced during pregnancy, coupled with a possible derangement of brain 5-hydroxytryptophan decarboxylase (a pyridoxal phosphate-dependent enzyme), leads to decreased brain 5-hydroxytryptamine and, hence, depression.