title: Cerebrospinal fluid levels of glutamate and corticotropin releasing hormone in major depression before and after treatment.
abstract: BACKGROUND
  Glutamate and corticotropin releasing hormone (CRH) are pro-stress neurotransmitters and may be altered in the plasma and cerebrospinal fluid (CSF) of persons with major depressive disorder (MDD). The goal of this study was to compare the CSF levels of glutamate, glutamine and CRH between patients with depression and healthy controls.
  
  
  METHODS
  Eighteen patients with MDD and 25 healthy controls underwent a lumbar puncture (LP); CSF samples were withdrawn and assays were done for glutamine, glutamate, and CRH. Patients with MDD underwent 8 weeks of treatment with the antidepressant venlafaxine and then had a repeat LP post treatment.
  
  
  RESULTS
  Patients had higher baseline scores on depression and suicide rating scales and those scales improved significantly post-treatment. Higher suicidal ratings at baseline were correlated with higher glutamate levels (p=0.016). There were no significant differences between the control and patient group in any baseline CSF measures of glutamate (p=0.761), glutamine (p=0.226) or CRH (p=0.675). Despite no significant change in glutamate (p=0.358) and CRH (p=0.331) in the treatment group, there was a post-treatment decrease in glutamine (p=0.045) in patients.
  
  
  CONCLUSIONS
  There was a small sample size, age discordance between patients and controls, lack of a follow-up LP in controls, absence of dexamethasone suppression testing, and fluctuating sample sizes among various measures.
  
  
  CONCLUSIONS
  Although no significant differences were noted between patients and controls at baseline there was an association of high CSF glutamate and suicidal ideation and lower glutamine post-treatment which may be correlated with attenuation of dysfunction in the glutamatergic system after antidepressant treatment.
authors: Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA. amir.garakani@mssm.edu
authors: Amir
authors: A
authors: Garakani
authors: Jose M
authors: JM
authors: Martinez
authors: Rachel
authors: R
authors: Yehuda
authors: Jack M
authors: JM
authors: Gorman
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003346:Corticotropin-Releasing Hormone / Q000134:cerebrospinal fluid*; D003511:Cyclohexanols / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000134:cerebrospinal fluid* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D018698:Glutamic Acid / Q000134:cerebrospinal fluid*; D005973:Glutamine / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008875:Middle Aged; D059020:Suicidal Ideation; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D003511:Cyclohexanols; D005973:Glutamine; D018698:Glutamic Acid; D000069470:Venlafaxine Hydrochloride; D003346:Corticotropin-Releasing Hormone