Study Sheds Light on Why Prozac Does Not Always Work
 

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By Amy Norton

NEW YORK (Reuters Health) - While Prozac and other antidepressants pull many people out of depression, they do not work for everyone. Now researchers may understand why.

In a study of 10 men with severe depression, investigators found distinct brain differences between those who improved on Prozac and those who did not. Brain scans revealed that although the drug reached the right brain areas in all of the men, some did not have what appears to be a necessary shift in brain metabolism.

Dr. Helen Mayberg of the Rotman Research Institute at Baycrest Centre for Geriatric Care in Toronto led the study. The results are published in the October 15th issue of Biological Psychiatry.

Prozac belongs to a drug class known as selective serotonin-reuptake inhibitors (SSRIs), which act on the brain chemical serotonin. But this study shows that the key to Prozac's success is not just a matter of tweaking serotonin levels, Mayberg told Reuters Health.

Instead, the four study subjects who felt better after 6 weeks on Prozac went through a complex series of metabolic changes in specific areas of the brain. The men who did not improve never made all of the necessary ``switches'' in brain metabolism. With antidepressant treatment, Mayberg said, ``you're retuning the system, not just filling up a low level of something.''

According to Mayberg's team, these complexities may explain two Prozac unknowns: why the drug does not work for all depressed people, and why it takes several weeks of treatment before people start feeling better.

Knowing exactly what is going on in the antidepressant-treated brain is important for several reasons, according to Mayberg. For one, she said, it shows scientists which brain areas need to be affected in order to help patients. Researchers can also look at whether it
possible to ''force a switch'' in patients' brain metabolism by upping the Prozac dose or using a different class of antidepressant.

SOURCE: Biological Psychiatry October 15, 2000.

 


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