Antidepressant response to electroconvulsive therapy is sustained after catecholamine depletion.
Although the antidepressant mechanism of ECT is unknown, there are data to support noradrenergic involvement. Patients who had been recently successfully treated with ECT for major depression were studied in a randomized double-blind cross-over design comparing catecholamine depletion using alpha-methyl-para-tyrosine to a placebo procedure. Mean MADRS scores at baseline (4.2 SD 2.7) and following depletion (4.6 SD 1.1) were similar, despite a 57.7% decrease in serum homovanillic acid (HVA) and a 61.5% decrease in 3-methoxy-4-hydroxyenylethyleneglycol (MHPG). These data suggest that catecholamine availability may not be necessary for acutely maintaining an antidepressant response to ECT.
Cassidy
Frederick
F
Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States; John Umstead Hospital, Butner, NC, United States. cassi002@mc.duke.edu
Weiner
Richard D
RD
Cooper
Thomas B
TB
Carroll
Bernard J
BJ
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002395:Catecholamines / Q000037:antagonists & inhibitors / Q000097:blood* / Q000502:physiology; D015331:Cohort Studies; D018592:Cross-Over Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000628:therapy; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D000928:Antidepressive Agents; D002395:Catecholamines