The cortical serotonin(2) receptors studied with positron-emission tomography and [F-18]-setoperone during depressive illness and antidepressant treatment with clomipramine

Background: Changes in serotonin (5-HT)(2) receptor densities were reported in depression by postmortem studies and following treatment with tricyclic antidepressants in animal studies. Here, 5-HT2 receptors were studied in v ivo in depressed patients. Methods: Cortical 5-HT2 receptors were investigated prospectively using pos itron-emission tomography and [F-18]-setoperone in 7 depressed patients, be fore and after at least 3 weeks of clomipramine (CMI), 150 mg daily. They w ere compared to 7 age-matched controls, Results: There was no significant difference between the untreated patients and the controls, except in the frontal region, where the [F-18]-setoperon e specific binding was slightly lower in patients. After CMI treatment depr ession scares significantly improved and [F-18]-setoperone specific binding decreased in cortical regions, suggesting receptor occupancy and/or recept or regulation, by CMI, however no clinical score correlated with the 5-HT2 receptor measurements either in the untreated or in the treated conditions. Conclusions: These data substantiate the view that tricyclic antidepressant s such as clomipramine significantly interact with cortical 5-HT2 serotonin ergic receptors in actual therapeutic situations. (C) 1999 Society of Biolo gical Psychiatry.