The Influence of Psychotherapy and Depression on Platelet Imipramine and Paroxetine Binding

Willis, Sarah Eveline (1993). The Influence of Psychotherapy and Depression on Platelet Imipramine and Paroxetine Binding. PhD thesis The Open University.



[3H]-Paroxetine and [3H]-imipramine are known to label with high affinity, a site which is associated with the serotonergic transporter in brain and platelets. [3H]-imipramine binding to platelet membranes appears to be a biological marker in depression, the Bmax of platelet imipramine binding being significantly decreased in untreated depressed patients by comparison with healthy volunteers.

Psychotherapy is claimed to produce significant improvement in depressed subjects without the use of drugs. This study aimed to determine whether differences were apparent in binding values for [3H]-paroxetine and [3H]-imipramine binding in subjects suffering from mild depression compared to controls, and how these values changed as the subjects went through a period of psychotherapy. In addition, psychiatric state was assessed using the BDI, the MAACL and the GHQ-28. Binding levels were then correlated with the scores obtained from the self-administered questionnaires to determine the relationship between binding and psychological state. Similar data were also collected from a group of nurses, who it was predicted would be suffering from a higher level of depression than the general population and would remain untreated.

The results from the psychotherapy group indicated that clients entering the study were significantly more depressed than controls (BDI P<0.05; MAACL P<0.01 GHQ-28 (excluding somatic symptoms) P<0.05) and had lower imipramine binding. Furthermore as they went through the period of psychotherapy their psychological test scores fell, and imipramine binding levels rose, to a level equivalent to the control values. Levels of [3H]-paroxetine binding to platelets did not appear to be affected by psychological state, at least in these patients.

In the group of nurses, both binding measurements were significantly lower than controls at most time points throughout the study (P<0.05) indicating lower affect. However psychological questionnaires indicated less distress in the nurses group than the control group (particularly BDI and GHQ-28). This is discussed in terms of possible coping strategies employed by nurses.

It was not possible to correlate the questionnaire scores with the results from the binding assays for clients, controls or nurses. There was no significant evidence of sex differences, either in binding parameters or questionnaire scores, and no evidence of seasonality of the binding levels. Proposals for future work are suggested.

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