VENLAFAXINE OR BUPROPION RESPONDERS BUT NOT NONRESPONDERS SHOW BASE-LINE PREFRONTAL AND PARALIMBIC HYPOMETABOLISM COMPARED WITH CONTROLS

In this study, 11 unipolar depressed outpatients received baseline (me dication-free) fluorine-18 deoxyglucose positron emission tomography s cans prior to randomization to double-blind venlafaxine or bupropion m onotherapy, with the option of a subsequent medication crossover. Base d on Clinical Global Impressions ratings, 6 of 11 responded to at leas t one medication. Regional cerebral glucose metabolic rate (rCMRglu) f or these 6 responders was compared with 18 age- and gender-matched hea lthy controls; the 5 nonresponders were compared with 15 matched healt hy controls. Compared with healthy controls, responders showed decreas ed (normalized > absolute) left middle frontal gyral, bilateral medial prefrontal, and bilateral temporal rCMRglu. In contrast, nonrespender s showed decreased (normalized > absolute) cerebellar rCMRglu. These p reliminary data suggest that among never-hospitalized unipolar depress ed outpatients, those showing baseline prefrontal and paralimbic hypom etabolism may be more likely to show a positive response to standard a ntidepressant treatments such as venlafaxine or bupropion.