Abstract
SPECT and PET imaging has played an important role in the evaluation of pharmaceutical interventions in mood disorders such as depression.
This review highlights the proposed role of monoamines, their precursors and the blood–brain barrier in depression and the antidepressant drug response. Reviewed are trials using SPECT and PET, including levodopa and carbidopa moclobemide and St. John’s wort; selegiline; the selective serotonin reuptake inhibitors (SSRIs) citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline; the noradrenaline-dopamine reuptake inhibitor (NDRI) bupropion; the serotonin-noradrenaline reuptake inhibitor (SNRI) venlafaxine; and the tricyclic antidepressants (TCAs) amitriptyline, nortriptyline and desipramine.
So far there is no apparent consensus on SPECT and PET imaging features for depression and its treatment, except that at least 80 % of serotonin transporters have to be occupied by serotonin reuptake inhibitors to achieve a clinically effective antidepressant drug response. The lack of characteristic imaging features may be due to inadequately designed imaging studies with insufficient in- and exclusion criteria, or it may be due to different aetiologies underlying the depressive state. Another possibility is that depression may be a non-regionalised phenomenon with global brain participation, similar to what has been proposed for the generation of the conscious condition.
In the future, it is likely that SPECT and PET imaging will remain an important tool and challenge in individual- and group-based approaches to obtain further information on depression and the antidepressant drug response.
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Acknowledgement
The authors would like to thank Dr S. Nikolaus, Dr H. Hautzel, and Prof KJ Langen for their valuable input in the consideration of this review.
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Clauss, R.P., Zöttl, M., Sathekge, M. (2014). Imaging of the Antidepressant Drug Response Using SPECT and PET. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., den Boer, J. (eds) PET and SPECT in Psychiatry. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40384-2_12
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