Decrease in brain serotonin 2 receptor binding in patients with major depression following desipramine treatment: a positron emission tomography study with fluorine-18-labeled setoperone.
BACKGROUND
The neuroreceptor changes involved in therapeutic efficacy of various antidepressants remain unclear. Preclinical studies have shown that long-term administration of various antidepressants causes down-regulation of brain serotonin 2 (5-HT2) receptors in rodents, but it is unknown if similar changes occur following antidepressant treatment in depressed patients. Our purpose, therefore, was to assess the effects of treatment with desipramine hydrochloride on brain 5-HT2 receptors in depressed patients using positron emission tomography (PET) and fluorine-18 (18F)-labeled setoperone.


METHODS
Eleven patients who met DSM-IV criteria for major depression as determined by a structured clinical interview for DSM-III-R diagnosis and suitable for treatment with desipramine were recruited. Ten patients underwent a PET scan before and another after 3 to 4 weeks of treatment with desipramine.


RESULTS
Eight of the 10 patients responded to desipramine treatment as indicated by more than 50% decrease in Hamilton Depression Rating Scale scores. Depressed patients showed a significant decrease in 5-HT2 receptor binding as measured by setoperone binding in frontal, temporal, parietal, and occipital cortical regions following desipramine treatment. The decrease in 5-HT2 receptor binding was observed bilaterally and was particularly prominent in frontal cortex.


CONCLUSIONS
Depressed patients showed a significant reduction in available 5-HT2 receptors in the brain following desipramine treatment, but it is unknown if this change in 5-HT2 receptors is due to clinical improvement or an effect of desipramine that is unrelated to clinical status.
Yatham
L N
LN
Division of Mood Disorders, The University of British Columbia, Vancouver, Canada. yatham@unixg.ubc.ca
Liddle
P F
PF
Dennie
J
J
Shiah
I S
IS
Adam
M J
MJ
Lane
C J
CJ
Lam
R W
RW
Ruth
T J
TJ
D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D003866:Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism; D003891:Desipramine / Q000494:pharmacology / Q000627:therapeutic use*; D015536:Down-Regulation / Q000187:drug effects; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D011744:Pyrimidinones; D011985:Receptors, Serotonin / Q000187:drug effects / Q000378:metabolism*; D014055:Tomography, Emission-Computed
D000929:Antidepressive Agents, Tricyclic; D005462:Fluorine Radioisotopes; D011744:Pyrimidinones; D011985:Receptors, Serotonin; D019788:Fluorodeoxyglucose F18; C045359:setoperone; D003891:Desipramine