This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (90)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Depression  • Psychopharmacology  • Psychotherapy  • Alert me on articles by topic  Social Bookmarking   What's this?

Preliminary Findings

Stephen D. Martin, MBBS,MRCPsych; Elizabeth Martin, RMN,BSc; Santoch S. Rai, MBChB,MRCPsych; Mark A. Richardson, BSc; Robert Royall, BSc,C.Eng,IEE,MIPEM

Arch Gen Psychiatry. 2001;58:641-648.

Background  Functional brain imaging studies in major depression have suggested abnormalities of areas, including the frontal cortex, cingulate gyrus, basal ganglia, and temporal cortex. We hypothesized that venlafaxine hydrochloride and interpersonal psychotherapy (IPT) might each alter brain blood flow in some or all of these areas on sequential single photon emission computed tomography (SPECT) scans.

Methods  Twenty-eight men and women aged 30 to 53 years with a DSM-IV major depressive episode, a 17-item Hamilton Rating Scale for Depression (HAM-D) rating of 18 or higher, and antidepressant-naive for at least 6 months were studied. After baseline ^99mtechnetium-hexa-methyl-propylene-amine-oxime scan, 1-T magnetic resonance imaging, and psychometric ratings, patients were assigned to different treatments. Thirteen patients had 1-hour weekly sessions of IPT from the same supervised therapist (E.M.). Fifteen patients took 37.5 mg twice-daily of venlafaxine hydrochloride. Single-photon emission computed tomography scans and ratings were repeated at 6 weeks.

Results  Both treatment groups improved substantially, more so with venlafaxine (mean [SD] HAM-D scores at pretreatment: IPT, 22.7 [2.7], and venlafaxine, 22.4 [3.1]; and posttreatment: IPT, 16.2 [7.1], and venlafaxine, 10.9 [8.6]). No patients had structural brain abnormalities. On analysis with statistical parametric mapping 96, the venlafaxine group showed right posterior temporal and right basal ganglia activation (P = .01), while the IPT group had limbic right posterior cingulate and right basal ganglia activation (P = .01).

Conclusions  This preliminary investigation has shown limbic blood flow increase with IPT yet not venlafaxine, while both treatments demonstrated increased basal ganglia blood flow. This was, however, a short trial with a small sample, no control group, and different symptom reduction in the 2 groups.

From the Research Unit, Cherry Knowle Hospital, Sunderland (Dr Martin and Ms Martin); the Hutton Centre, St Lukes Hospital, Middlesbrough (Dr Rai); and the Northern Regional Medical Physics Department, South Cleveland Hospital, Middlesbrough (Messrs Richardson and Royall, England).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Regional Brain Metabolic Changes in Patients With Major Depression Treated With Either Paroxetine or Interpersonal Therapy: Preliminary Findings
Arthur L. Brody, Sanjaya Saxena, Paula Stoessel, Laurie A. Gillies, Lynn A. Fairbanks, Shervin Alborzian, Michael E. Phelps, Sung-Cheng Huang, Hsiao-Ming Wu, Matthew L. Ho, Mai K. Ho, Scott C. Au, Karron Maidment, and Lewis R. Baxter, Jr
Arch Gen Psychiatry. 2001;58(7):631-640.
ABSTRACT | FULL TEXT  

Functional Brain Circuits in Major Depression and Remission
Harold A. Sackeim
Arch Gen Psychiatry. 2001;58(7):649-650.
EXTRACT | FULL TEXT  

Neuroimaging Profiles and the Differential Therapies of Depression
Michael E. Thase
Arch Gen Psychiatry. 2001;58(7):651-653.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Special Section: On Looking Inward: Revisiting the Role of Introspection in Neuroscientific and Psychiatric Research
den Boer et al.
Theory Psychology 2008;18:380-403.
ABSTRACT  

Self-Control as an Executive Function: Reformulating Gottfredson and Hirschi's Parental Socialization Thesis
Beaver et al.
Criminal Justice and Behavior 2007;34:1345-1361.
ABSTRACT  

Identifying Functional Neuroimaging Biomarkers of Bipolar Disorder: Toward DSM-V
Phillips and Vieta
Schizophr Bull 2007;33:893-904.
ABSTRACT | FULL TEXT  

The Emerging Role of Neuroimaging in Psychiatry: Characterizing Treatment-Relevant Endophenotypes
Phillips
Am. J. Psychiatry 2007;164:697-699.
FULL TEXT  

Differences in Brain Glucose Metabolism Between Responders to CBT and Venlafaxine in a 16-Week Randomized Controlled Trial
Kennedy et al.
Am. J. Psychiatry 2007;164:778-788.
ABSTRACT | FULL TEXT  

Lack of Ventral Striatal Response to Positive Stimuli in Depressed Versus Normal Subjects
Epstein et al.
Am. J. Psychiatry 2006;163:1784-1790.
ABSTRACT | FULL TEXT  

Response-Dependent Differences in Regional Cerebral Blood Flow Changes with Citalopram in Treatment of Major Depression
Joe et al.
JNM 2006;47:1319-1325.
ABSTRACT | FULL TEXT  

The Clinical Conduct of Interpersonal Psychotherapy
Markowitz
Focus 2006;4:179.
ABSTRACT | FULL TEXT  

Neurobiological Mechanisms of the Placebo Effect
Benedetti et al.
J. Neurosci. 2005;25:10390-10402.
FULL TEXT  

Toward a Neurobiology of Psychotherapy: Basic Science and Clinical Applications
Etkin et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:145-158.
ABSTRACT | FULL TEXT  

Attenuation of the Neural Response to Sad Faces in Major Depression by Antidepressant Treatment: A Prospective, Event-Related Functional Magnetic Resonance Imaging Study
Fu et al.
Arch Gen Psychiatry 2004;61:877-889.
ABSTRACT | FULL TEXT  

Modulation of Cortical-Limbic Pathways in Major Depression: Treatment-Specific Effects of Cognitive Behavior Therapy
Goldapple et al.
Arch Gen Psychiatry 2004;61:34-41.
ABSTRACT | FULL TEXT  

The Emerging Dialogue Between Psychoanalysis and Neuroscience: Neuroimaging Perspectives
Beutel et al.
J Am Psychoanal Assoc 2003;51:773-801.
ABSTRACT  

Controlled Clinical Trial of Interpersonal Psychotherapy Versus Parenting Education Program for Depressed Pregnant Women
Spinelli and Endicott
Am. J. Psychiatry 2003;160:555-562.
ABSTRACT | FULL TEXT  

Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment
Mayberg
Br Med Bull 2003;65:193-207.
ABSTRACT | FULL TEXT  

Changes in Regional Cerebral Blood Flow With Venlafaxine in the Treatment of Major Depression
Davies et al.
Am. J. Psychiatry 2003;160:374-376.
ABSTRACT | FULL TEXT  

The Neural Substrates of Affective Processing in Depressed Patients Treated With Venlafaxine
Davidson et al.
Am. J. Psychiatry 2003;160:64-75.
ABSTRACT | FULL TEXT  

The Functional Neuroanatomy of the Placebo Effect
Mayberg et al.
Am. J. Psychiatry 2002;159:728-737.
ABSTRACT | FULL TEXT  

The Fate of Integrated Treatment: Whatever Happened to the Biopsychosocial Psychiatrist?
Gabbard and Kay
Am. J. Psychiatry 2001;158:1956-1963.
ABSTRACT | FULL TEXT  

Functional Neuroanatomy of Remission from Depression
JWatch Psychiatry 2001;2001:3-3.
FULL TEXT  

Functional Brain Circuits in Major Depression and Remission
Sackeim
Arch Gen Psychiatry 2001;58:649-650.
FULL TEXT  

Neuroimaging Profiles and the Differential Therapies of Depression
Thase
Arch Gen Psychiatry 2001;58:651-653.
FULL TEXT