title: Platelet thromboxane A2 secretion in patients with major depression responsive to electroconvulsive therapy.
abstract: 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.
authors: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
authors: Erica C
authors: EC
authors: Bruce
authors: Ying
authors: Y
authors: Guo
authors: Kathryn C
authors: KC
authors: Lawson
authors: Amita K
authors: AK
authors: Manatunga
authors: S Freda
authors: SF
authors: Auyeung
authors: William M
authors: WM
authors: McDonald
authors: Natasha
authors: N
authors: Rushing
authors: Angelo R
authors: AR
authors: Brown
authors: Natalie
authors: N
authors: Gilles
authors: Milburn
authors: M
authors: Emery
authors: Robert
authors: R
authors: Bonsall
authors: Jocelyn
authors: J
authors: Porquez
authors: Zachary
authors: Z
authors: Stowe
authors: Charles B
authors: CB
authors: Nemeroff
authors: Dominique L
authors: DL
authors: Musselman
mesh_terms: 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
chemical_list: D013929:Thromboxane B2; D013928:Thromboxane A2; C049235:11-dehydro-thromboxane B2