Background
To our knowledge, no studies have investigated the predictive value of central serotonin
transporter (SERT) availability for treatment response to serotonin reuptake inhibitors
(SSRIs) in patients with obsessive–compulsive disorder (OCD). This study used brain
imaging to examine the relationship between pretreatment SERT availability and transporter
occupancy as well as treatment response by sertraline in patients displaying prominent
behavioral checking compulsions (OC checkers).
Methods
Single photon emission computed tomography (SPECT) was used to measure thalamic-hypothalamic
SERT availability with [123I]-2β-carbomethoxy-3β-(4-iodophenyl)-tropane in 28 nondepressed OC checkers at baseline
and after 14 weeks of treatment with sertraline (175 mg daily). SERT availability
was correlated with OC severity and treatment response as assessed with the Yale-Brown
Obsessive-Compulsive Scale (Y-BOCS). Associations between individual transporter occupancies
and clinical parameters were investigated.
Results
1) Correlation analyses between thalamic-hypothalamic SERT availability and OC severity
showed significant negative associations at baseline and after treatment with sertraline.
2) Pretreatment SERT availability correlated significantly with both transporter occupancy
and treatment response; in addition, a positive association was found between transporter
occupancy and treatment response directly. 3) Using multivariate statistical models,
the data demonstrated that higher pretreatment SERT availability significantly predicted
higher occupancy rates as well as better treatment response 14 weeks later.
Conclusions
Higher pretreatment thalamic-hypothalamic SERT availability may predict both higher
occupancy rates and better treatment response to sertraline. The data suggest a strong
connection between transporter occupancy and treatment response.
Key Words
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Article info
Publication history
Published online: September 01, 2009
Accepted:
July 14,
2009
Received in revised form:
July 1,
2009
Received:
March 3,
2009
Identification
Copyright
© 2009 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
