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September 10, 2003

Neurochemical Aspects of Susceptibility to DepressionNeurochemical Aspects of Susceptibility to Depression

JAMA. 2003;290(10):1315-1316. doi:10.1001/jama.290.10.1315

To the Editor: Dr Bremner and colleagues1 found that depletion of norepinephrine and dopamine with α-methylparatyrosine (AMPT) induced a return of depressive symptoms in 11 of 18 patients receiving desipramine. They also found that this was associated with significant decreases in brain metabolic activity in the dorsolateral prefrontal and orbitofrontal cortex and thalamus as measured by positron emission tomography (PET). The authors suggested that these findings of regional reductions in brain metabolic activity are similar to those of their previous study of tryptophan depletion, in which return of depressive symptoms in patients receiving serotonin reuptake inhibitors was associated with similar regional changes.2 These findings indicate that serotonergic and catecholaminergic systems may have common postsynaptic effects in brain regions involved in mediating depressive symptoms, perhaps through complex interactions among monoaminergic systems.

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