0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter to the Editor   |    
Dr. Campbell and Colleagues Reply
STEPHANIE CAMPBELL, Ph.D.; MICHAEL MARRIOTT, Ph.D.; CLAUDE NAHMIAS, Ph.D.; GLENDA M. MacQUEEN, M.D., Ph.D., F.R.C.P.C.
Am J Psychiatry 2005;162:629-a-629. doi:10.1176/appi.ajp.162.3.629-a

To the Editor: Dr. van Elst makes valid points regarding the issue of measuring amygdala volumes in patients with depression. The focus of our analysis was the hippocampus, and therefore, we did not review the literature on amygdala volume measurements independent of the hippocampus in detail. There are several studies focusing exclusively on amygdala volumes, including one examining core amygdala volumes, which recognize not only the difficulty of imaging various nuclei of the amygdala but also the relevance of the fact that there are distinct functional differences between nuclei (1). Perhaps the most intriguing point that Dr. van Elst makes is that medication effects need to be examined in future studies. A recent preliminary report in this Journal(2) suggests that volumetric reduction of the hippocampus may be more a function of time spent ill and untreated than time spent ill and treated. Apart from this report, however, there is little known about the long-term impact of antidepressant or other psychotropic medications on specific brain regions, despite the increasing body of preclinical literature suggesting that some psychotropic medications may have neuroprotective effects and that long-term pharmacotherapy in patients with mood disorders may improve outcome. Harvey and colleagues (3) recently highlighted another important issue regarding medication, that is, the effect of repeated antidepressant withdrawal on brain regions such as the hippocampus. It is also apparent from their review that there are few data to inform us regarding the long-term effects of repeated trials and subsequent withdrawals of antidepressant medications. Despite the current lack of information describing the long-term effects of psychotropic medications on brain morphometry, we fully agree with Dr. van Elst that this is an important area for future study.

Sheline YI, Gado MH, Price JL: Amygdala core nuclei volumes are decreased in recurrent major depression. Neuroreport  1998; 9:2023–2028; correction, 9:2436
[PubMed]
[CrossRef]
 
Sheline YI, Gado MH, Kraemer HV: Untreated depression and hippocampal volume loss. Am J Psychiatry  2003; 160:1516–1518
[PubMed]
[CrossRef]
 
Harvey BH, McEwen BS, Stein DJ: Neurobiology of antidepressant withdrawal: implications for the longitudinal outcome of depression. Biol Psychiatry  2003; 54:1105–1117
[PubMed]
[CrossRef]
 
+

References

Sheline YI, Gado MH, Price JL: Amygdala core nuclei volumes are decreased in recurrent major depression. Neuroreport  1998; 9:2023–2028; correction, 9:2436
[PubMed]
[CrossRef]
 
Sheline YI, Gado MH, Kraemer HV: Untreated depression and hippocampal volume loss. Am J Psychiatry  2003; 160:1516–1518
[PubMed]
[CrossRef]
 
Harvey BH, McEwen BS, Stein DJ: Neurobiology of antidepressant withdrawal: implications for the longitudinal outcome of depression. Biol Psychiatry  2003; 54:1105–1117
[PubMed]
[CrossRef]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 1.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 47.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 45.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 1.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 51.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles