Selegiline remarkably improved stage 5 treatment-resistant major depressive disorder: a case report.

Abstract

We report a case in which selegiline, an irreversible monoamine oxidase B (MAO-B) inhibitor, greatly improved depressive symptoms in an adult with stage 5 treatment-resistant major depressive disorder. Four antidepressants and four augmentation therapies had previously been ineffective or intolerable, and electroconvulsive therapy had only a temporary effect. After 20 weeks of treatment with selegiline (10 mg/day), the patient's score on the 17-item Hamilton Depression Rating Scale (HDRS) had decreased from 19 to 4 points. [(18)F]-Fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased glucose metabolism in the bilateral basal ganglia after initiating selegiline treatment; blood dopamine levels were also increased after selegiline treatment. These results raise the possibility that selegiline enhances dopamin-ergic neural transmission in treatment-resistant depression, thus leading to an improvement in depressive symptoms.

• Authors: Yuji Kitaichi, Takeshi Inoue, Nobuyuki Mitsui, Shin Nakagawa, Rie Kameyama, Yoshiyuki Hayashishita, Tohru Shiga, Ichiro Kusumi, Tsukasa Koyama
• Journal: Neuropsychiatric disease and treatment (Neuropsychiatr Dis Treat) Vol. 9 Pg. 1591-4 ( 2013) ISSN: 1176-6328 [Print] New Zealand
• PMID: 24204150 (Publication Type: Case Reports)