Effect of electroconvulsive therapy on brain 5-HT2 receptors in major depression

被引:68
作者
Yatham, Lakshmi N. [1 ]
Liddle, Peter F. [2 ]
Lam, Raymond W. [1 ]
Zis, Athanasios P. [1 ]
Stoessl, A. Jon [3 ]
Sossi, Vesna [3 ]
Adam, Michael J. [3 ,4 ]
Ruth, Thomas J. [3 ,4 ]
机构
[1] Univ British Columbia, Dept Psychiat, Vancouver, BC V6T 2A1, Canada
[2] Univ Nottingham, Dept Psychiat, Nottingham NG7 2RD, England
[3] Univ British Columbia, Pacific Parkinsons Res Ctr, Vancouver, BC V6T 2A1, Canada
[4] Univ British Columbia, TRIUMF, Vancouver, BC V6T 2A1, Canada
基金
加拿大健康研究院;
关键词
POSITRON-EMISSION-TOMOGRAPHY; DOUBLE-BLIND; SEROTONIN(2) RECEPTORS; BIPOLAR-I; BINDING; PET; OLANZAPINE; SHOCK; HALOPERIDOL; FLUOXETINE;
D O I
10.1192/bjp.bp.109.069567
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background Brain serotonin(2) (5-hydroxytryptamine(2); 5-HT2) receptors were considered potential targets for therapeutic efficacy of electroconvulsive therapy (ECT), but pre-clinical studies showed that electroconvulsive shock up-regulates 5-HT2 receptors in contrast to antidepressant medications, which down-regulate brain 5-HT2 receptors. Positron emission tomography (PET) studies in individuals with depression confirmed that antidepressant medications reduce brain 5-HT2 receptors, but the effects of ECT on these receptors in individuals with depression are unknown. Aims To determine if a course of ECT alters brain 5-HT2 receptors in individuals with depression and whether such changes correlate with improvement in symptoms. Method Fifteen people with major depression, refractory to antidepressant therapy and referred for a course of ECT, had an [F-18]setoperone scan during baseline drug-free washout period and another after a course of ECT. We assessed changes in brain 5-HT2 receptors with ECT and their relationship to therapeutic outcome. Results Widespread reduction in brain 5-HT2 receptors was observed in all cortical areas with changes slightly more prominent in the right hemisphere. There was a trend for correlation between reduction in brain 5-HT2 receptors in right parahippocampal gyrus, right lingual gyrus and right medial frontal gyrus, and improvement in depressive symptoms. Conclusions Unlike in rodents, and similar to antidepressants, ECT reduces brain 5-HT2 receptors in individuals with depression. The ability of ECT to further down-regulate brain 5-HT2 receptors in antidepressant non-responsive individuals may explain its efficacy in those people with antidepressant refractory depression.
引用
收藏
页码:474 / 479
页数:6
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