title: Selegiline remarkably improved stage 5 treatment-resistant major depressive disorder: a case report.
abstract: We report a case in which selegiline, an irreversible monoamine oxidase B (MAO-B) inhibitor, greatly improved depressive symptoms in an adult with stage 5 treatment-resistant major depressive disorder. Four antidepressants and four augmentation therapies had previously been ineffective or intolerable, and electroconvulsive therapy had only a temporary effect. After 20 weeks of treatment with selegiline (10 mg/day), the patient's score on the 17-item Hamilton Depression Rating Scale (HDRS) had decreased from 19 to 4 points. [(18)F]-Fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased glucose metabolism in the bilateral basal ganglia after initiating selegiline treatment; blood dopamine levels were also increased after selegiline treatment. These results raise the possibility that selegiline enhances dopamin-ergic neural transmission in treatment-resistant depression, thus leading to an improvement in depressive symptoms.
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kitaichi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Mitsui
authors.forename: Shin
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Rie
authors.initials: R
authors.lastname: Kameyama
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hayashishita
authors.forename: Tohru
authors.initials: T
authors.lastname: Shiga
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kusumi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Koyama
keywords: FDG-PET; basal ganglia; glucose metabolism; treatment-resistant depression