Posted by SLS on August 3, 2003, at 19:40:18
In reply to Other brain questions, posted by Zenclearer on August 2, 2003, at 10:13:26
From Medscape:
Antidepressants May Protect Against Hippocampal Volume Loss
Laurie Barclay, MD
Aug. 1, 2003 — Antidepressants may protect against hippocampal volume loss associated with depression, according to the results of a small trial published in the August issue of the American Journal of Psychiatry. The amount of volume loss was predictable from the number of days depressed versus the number of days receiving antidepressant treatment."Our results suggest that if a woman takes antidepressants whenever she is depressed, depression would have less effect on the volume of her hippocampus," lead author Yvette I. Sheline, MD, from Washington University School of Medicine in St. Louis, Missouri, says in a news release. "It is the untreated days that seem to affect hippocampal volumes."
Using high-resolution magnetic resonance imaging (MRI), the investigators measured hippocampal volume in 38 female outpatients with major depression and in 38 controls matched for age, education, and height. On average, the depressed women had a previous history of five depressive episodes, only some of which were treated with antidepressant drugs. Each woman was interviewed by two independent interviewers to determine the duration of each depressive episode and of antidepressant treatment.
Hippocampal volume was smaller in depressed women than in controls. Longer episodes during which depression was untreated with antidepressants was directly correlated with decreases in hippocampal volume.
"We've shown in other studies that people with hippocampal damage also have problems with certain memory tests," Dr. Sheline says. "Large epidemiology studies have shown that major depression is a risk factor for the later development of Alzheimer's disease. So it seems clear that volume loss in the hippocampus can have very negative effects, not to mention the devastating problems caused by depression itself."
The mechanism of hippocampal atrophy is not clear, but it may involve cortisol or other neurotransmitters released during depression damaging neurons or synapses. Animal models also suggest that antidepressant drugs may protect against stress-induced hippocampal volume loss. This study did not distinguish the effects of specific antidepressants.
According to the investigators, cumulative hippocampal volume loss with repeated depressive episodes mandates early recognition and treatment.
"Many psychiatrists already recommend that some patients who are prone to depression remain on antidepressants permanently to protect against depression," Dr. Sheline says. "These apparent neuroprotective effects provide a further argument for at least strongly considering remaining on antidepressants."
The National Institute of Mental Health and the Division of Research Resources of the National Institutes of Health supported this research through grants.
Am J Psychiatry. 2003;160(6):1516-1518
Reviewed by Gary D. Vogin, MD
poster:SLS
thread:247363
URL: http://www.dr-bob.org/babble/20030802/msgs/247872.html