ISSN:
1432-2072
Keywords:
Reserpine
;
Desipramine
;
Antidepressants
;
Refractory depression
;
MHPG
;
HVA
;
5-HIAA
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Early studies showed dramatic improvement in some depressed patients when a brief course of parenteral reserpine was added to ineffective tricyclic antidepressant (TCA) treatment. We treated eight patients with DSM-III melancholic major depression with desipramine (DMI)≥2.5 mg/kg/day (plasma levels〉125 ng/ml) for at least 4 weeks. All patients failed to respond and received reserpine 5 mg IM b.i.d. over 2 days, in seven cases as a placebo-controlled, double-blind trial. One patient had dramatic resolution of depressive and psychotic symptoms within 48 h, but relapsed within 2 weeks; two other patients had transient hypomanic symptoms. Depression ratings did not significantly change for the sample as a whole, but plasma and cerebrospinal fluid (CSF) levels of 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) decreased and CSF levels of homovanillic acid (HVA) and 5-hydroxy-indoleacetic acid (5-HIAA) increased. Despite robust effects on central monoamine metabolism, reserpine augmentation appears insufficiently effective for routine use in managing refractory depression.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00176473
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