Neural Correlates of Depressive Symptoms and Reward Related Mechanisms Following AMPT Depletion in Remitted Depressed Patients Off Treatment and Healthy Controls

Date de début de l'étude : 19 avril 2004

* INCLUSION CRITERIA: MDD Sample: 40 subjects (ages 18-45) with remitted MDD will be selected. MDD is defined by the DSM-IV criteria, and one of the following additional criteria: 1. history of two or more major depressive episodes, or 2. history of one major depressive episode and a family history for major depression. Remission is defined as a period of at least three months during which the subject has not taken any antidepressant agents, with the Hamilton Depression Rating Scale (HDRS; 21-item) scores in the non-depressed range (less than 8), and with no more than one clinically significant depressive symptom. Unaffected MDD Relative Sample: 40 healthy relatives of MDD probands (ages 18-45) will be recruited. Subjects will be screened to ensure that they have no history of psychiatric illness. Unaffected BD Relative Sample: Healthy relatives of BD probands (ages 18-45) will be recruited. Subjects will be screened to ensure that they have no history of psychiatric illness. Healthy Control Samples: -Healthy subjects (ages 18-45) without a known personal or first-degree family history of psychiatric disorders in first-degree relatives will be selected. EXCLUSION CRITERIA: * Any subject who appears incapable of providing informed consent will be excluded from the study. * Subjects who take effective antidepressant medication * Subjects must not have taken antidepressant or other medications likely to alter monoamine neurochemistry or cerebrovascular and cardiovascular function for at least 3 months prior to the studies. * Subjects who have: 1. psychosis to the extent that the ability to provide informed consent is in doubt 2. medical or neurological illnesses likely to affect physiology or anatomy, i.e. hypertension, cardiovascular disorders 3. a history of drug (including benzodiazepines \[BZD\]) or alcohol abuse within 1 year or a lifetime history of alcohol or drug dependence (DSM IV criteria) longer than 2 years 4. current pregnancy (as documented by pregnancy testing at screening or at days of the challenge studies) 5. current breast feeding 6. smokers 7. serious suicidal ideation or behavior 8. general MRI exclusion criteria (e.g., subjects with metallic implants that are ferromagnetic will be excluded from the fMRI scanning). Subjects must exhibit no or only moderate alcohol use. Subjects with current excessive use of alcohol (greater than 4 ounces/day for men and greater than 3 ounces/day for women) are ineligible for participation, as such drug use confounds the results 9. smokers are ineligible because of the evidence for interactions between nicotine and depression, and the possibility of withdrawal symptoms that may affect behavioral and neural responses to CD 10. history of suicidality and other axis I diagnoses beside major depressive disorder 11. lactose intolerance 12. women not using a reliable contraception method. Finally subjects who have had an upper respiratory tract infection in the last week will be excluded as this may impact sense of smell. * Subjects beyond age 45 * Individuals whose first major depressive episodes arose after other medical or psychiatric conditions * Subjects showing significant side effects during AMPT depletion such as dystonic reactions will receive adequate treatment and will be excluded from the study