title: Venlafaxine or bupropion responders but not nonresponders show baseline prefrontal and paralimbic hypometabolism compared with controls.
abstract: In this study, 11 unipolar depressed outpatients received baseline (medication-free) fluorine-18 deoxyglucose positron emission tomography scans prior to randomization to double-blind venlafaxine or bupropion monotherapy, with the option of a subsequent medication crossover. Based on Clinical Global impressions ratings, 6 of 11 responded to at least one medication. Regional cerebral glucose metabolic rate (rCMRglu) for these 6 responders was compared with 18 age- and gender-matched healthy controls; the 5 nonresponders were compared with 15 matched healthy controls. Compared with healthy controls, responders showed decreased (normalized > absolute) left middle frontal gyral, bilateral medial prefrontal, and bilateral temporal rCMRglu. In contrast, nonresponders showed decreased (normalized > absolute) cerebellar rCMRglu. These preliminary data suggest that among never-hospitalized unipolar depressed out-patients, those showing baseline prefrontal and paralimbic hypometabolism may be more likely to show a positive response to standard antidepressant treatments such as venlafaxine or bupropion.
authors.affiliation: Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Little
authors.forename: T A
authors.initials: TA
authors.lastname: Ketter
authors.forename: T A
authors.initials: TA
authors.lastname: Kimbrell
authors.forename: A
authors.initials: A
authors.lastname: Danielson
authors.forename: B
authors.initials: B
authors.lastname: Benson
authors.forename: M W
authors.initials: MW
authors.lastname: Willis
authors.forename: R M
authors.initials: RM
authors.lastname: Post
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D016642:Bupropion / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation; D003511:Cyclohexanols / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging*; D014055:Tomography, Emission-Computed; D000069470:Venlafaxine Hydrochloride
chemical_list: D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D016642:Bupropion; D000069470:Venlafaxine Hydrochloride