Elevated midbrain serotonin transporter availability in mixed mania: a case report

BMC Psychiatry. 2004 Sep 13:4:27. doi: 10.1186/1471-244X-4-27.

Abstract

Background: Results obtained from brain imaging studies indicate that serotonin transporter (SERT) and dopamine transporter (DAT) densities are altered in major depression. However, no such studies have been published on current mania or hypomania.

Case presentation: In this single photon emission computed tomography (SPECT) study with [123I]nor-beta-CIT we present a case with simultaneous symptoms of major depression and hypomania. She had an elevated serotonin transporter availability (SERT) in the midbrain and elevated dopamine transporter availability (DAT) in the striatum, which normalised in a one-year follow-up period during which she received eight months of psychodynamic psychotherapy.

Conclusions: To our knowledge, this is the first report on SERT and DAT associated with mania. In our case the availability of both SERT in the midbrain and DAT in the striatum were elevated at baseline and declined during psychotherapy, while the SERT and DAT of the depressed controls increased during psychotherapy. Symptoms of hypomania in the case were alleviated during psychotherapy. Clinical recovery was also reflected in the Hamilton Depression Rating Scale (HDRS) scores.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / diagnostic imaging
  • Bipolar Disorder / metabolism*
  • Cocaine / analogs & derivatives*
  • Corpus Striatum / chemistry
  • Corpus Striatum / diagnostic imaging
  • Corpus Striatum / metabolism
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / diagnostic imaging
  • Depressive Disorder, Major / metabolism
  • Dopamine Plasma Membrane Transport Proteins
  • Female
  • Humans
  • Iodine Radioisotopes
  • Membrane Glycoproteins / analysis
  • Membrane Glycoproteins / metabolism*
  • Membrane Transport Proteins / analysis
  • Membrane Transport Proteins / metabolism*
  • Mesencephalon / chemistry
  • Mesencephalon / diagnostic imaging
  • Mesencephalon / metabolism*
  • Nerve Tissue Proteins / analysis
  • Nerve Tissue Proteins / metabolism*
  • Psychiatric Status Rating Scales
  • Psychotherapy
  • Serotonin Plasma Membrane Transport Proteins
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Dopamine Plasma Membrane Transport Proteins
  • Iodine Radioisotopes
  • Membrane Glycoproteins
  • Membrane Transport Proteins
  • Nerve Tissue Proteins
  • SLC6A3 protein, human
  • SLC6A4 protein, human
  • Serotonin Plasma Membrane Transport Proteins
  • N-nor-3-(4'-iodophenyl)tropane-2-carboxylic acid methyl ester
  • Cocaine