RT Journal Article
SR Electronic
T1 Effects of dopamine agonists in antidepressant-resistant depression on cerebral metabolism
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 273
OP 273
VO 51
IS supplement 2
A1 Reiko Usui
A1 Tohru Shiga
A1 Kenji Hirata
A1 Nagara Tamaki
A1 Naoya Hattori
A1 Takeshi Inoue
YR 2010
UL http://jnm.snmjournals.org/content/51/supplement_2/273.abstract
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