Antidepressants
protect against loss of hippocampal
volume
Depression
has been associated with a reduction in the
volume of hippocampus. The effect of
antidepressant treatment on hippocampal volumes
has been studied in patients with major
depression.
Hippocampal gray matter volume was determined in
38 female outpatients suffering from major
depression and in 38 controls matched for age,
education, and height, using high resolution
magnetic resonance imaging and unbiased
stereological measurement. In general, the
previous history of the depressed women
consisted of five depressive episodes, only some
of which were treated with antidepressants. Two
independent interviewers asked each women to
indicate the number of days in each depressive
episode during which antidepressant medication
was taken.
Depressed women had smaller hippocampal volume
than controls. There was an association between
the longer episodes during which depression was
untreated and decreases in hippocampal volume.
The cumulative hippocampal volume loss shown in
this study strongly dictates the necessity for
early recognition and treatment of depression.
The consequence of hippocampal atrophy must be
seriously considered since other studies have
shown that hippocampal damage is also associated
with memory loss and epidemiological studies
have indicated that major depression is a risk
factor for the development of Alzheimer's
disease. The possible neuroprotective effect of
antidepressants during depression represents a
solid argument for prolonging antidepressant
therapy in some patients at risk of further
depressive episodes. Am
J Psychiatry 160: 1516-1518, 2003