Platelet thromboxane A2 secretion in patients with major depression responsive to electroconvulsive therapy.
OBJECTIVE
To determine a) whether clinical response to electroconvulsive therapy (ECT) is associated with decreased platelet activation in patients with major depressive disorder (MDD) and b) if any medical/demographic characteristics predict response to ECT or changes in platelet activation. Increased platelet activation may underlie the increased risk of coronary artery disease (CAD) in patients with MDD.


METHODS
Before their first and sixth ECT treatments, study patients (n = 44) completed the Beck Depression Inventory (BDI) to assess the severity of depressive symptoms. Activity of the platelet thromboxane (TBX) A(2) pathway was assessed by measuring the morning spot urinary concentrations of 11-dehydroxy-thromboxane B(2) (11-D-TBX B(2)), a major metabolite of platelet-derived TBX A(2).


RESULTS
Multivariate logistic regression analyses revealed that improvement on the BDI was significantly more likely in patients without a history of hypertension (p = .02) and in patients who were prescribed a greater number of "platelet-altering" medications (p = .03). During a course of ECT, a decrease in urinary 11-D-TBX B(2) was significantly more likely to occur in ECT nonresponders (p = .01) and younger patients (p = .02).


CONCLUSIONS
Clinical response to ECT coadministered may not be associated with decreases in platelet-derived TBX. Future studies will confirm which somatic "antidepression" treatments offer optimal thrombovascular benefits for depressed patients with multiple risk factors for, or clinically evident, cerebral disease or CAD.
Bruce
Erica C
EC
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Guo
Ying
Y
Lawson
Kathryn C
KC
Manatunga
Amita K
AK
Auyeung
S Freda
SF
McDonald
William M
WM
Rushing
Natasha
N
Brown
Angelo R
AR
Gilles
Natalie
N
Emery
Milburn
M
Bonsall
Robert
R
Porquez
Jocelyn
J
Stowe
Zachary
Z
Nemeroff
Charles B
CB
Musselman
Dominique L
DL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000097:blood; D003865:Major Depressive Disorder / Q000097:blood* / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010555:Personality Inventory; D015539:Platelet Activation / Q000502:physiology; D012307:Risk Factors; D013928:Thromboxane A2 / Q000097:blood*; D013929:Thromboxane B2 / Q000031:analogs & derivatives / Q000652:urine; D016896:Treatment Outcome
D013929:Thromboxane B2; D013928:Thromboxane A2; C049235:11-dehydro-thromboxane B2