PT - JOURNAL ARTICLE AU - Reiko Usui AU - Tohru Shiga AU - Kenji Hirata AU - Nagara Tamaki AU - Naoya Hattori AU - Takeshi Inoue TI - Effects of dopamine agonists in antidepressant-resistant depression on cerebral metabolism DP - 2010 May 01 TA - Journal of Nuclear Medicine PG - 273--273 VI - 51 IP - supplement 2 4099 - http://jnm.snmjournals.org/content/51/supplement_2/273.short 4100 - http://jnm.snmjournals.org/content/51/supplement_2/273.full SO - J Nucl Med2010 May 01; 51 AB - 273 Objectives Refractory depression has been a difficult theme for clinicians for a long time. Several studies have demonstrated that direct and indirect dopamine agonists have antidepressant effect. We studied to define the clinical effect of dopamine agonist on refractory depression and the correlation between the efficacy and cerebral metabolism. Methods We evaluated the efficacy of 8-week treatment with dopamine agonist as an antidepressant adjuvant using clinical scores, such as 17-item Hamilton Depression Rating Scale (HAM-D) and Montgomery-Åsberg Depression Rating Scale (MADRS). Nine unipolar depressed patients who were refractory to at least two adequate antidepressant trials were studied by FDG-PET using visual analysis before and after the treatment. Results Dopamine agonist (eight patients Pramipexole, one Cabergoline) was effective in five patients in both HAM-D and MADRS scores. Improvement of these scores approached statistical significance.(p < 0.01) Of five patients showing abnormal FDG uptake before treatment, four (80%) improved the scores with dopamine agonists. On the contrary, of four patients showing normal FDG uptake, only one (25%) improved the scores. The regions of abnormal FDG uptake were left thalamus (two patients), bilateral frontal lobe (two), bilateral temporal lobe (two), bilateral thalamus (one) right temporal lobe (one), or left basal ganglia (one). Most of these abnormalities at FDG-PET improved after treatment. Conclusions Dopamine agonist is effective in patients with antidepressant-resistant depression. FDG-PET before treatment may hold a potential for predicting the treatment effect