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Common Antidepressant Sertraline May Change Brain Structures

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A new research at Wake Forest Baptist Medical Center has revealed a worrying fact about a common antidepressant. It says that this prescribed antidepressant behaves differently in people who are suffering from depression and those who are not. In fact, it says that it can alter brain structures in depressed and non-depressed individuals in very different ways.

For this study, nonhuman primates who have brain structures similar and functions to humans were considered. The study found that the antidepressant sertraline, a selective serotonin reuptake inhibitor (SSRI) which is marketed as Zoloft, did something strange in brain. It decreased the volume of two brain areas in non-depressed subjects and significantly increased the volume of one brain region in depressed subjects. The reason these observations are significant is because Zoloft is widely prescribed not only for depression but for a number of other disorders as well. The study was published in an online issue of the journal Neuropharmacology recently.

Carol A. Shively, Ph.D., professor of pathology-comparative medicine at Wake Forest Baptist and lead author of the study said that the observations made are of great significance for human health as rampant use of Zoloft could do more harm than good.

Researchers experimented on a group of 41 middle-aged monkeys. For 18 months they were fed with a diet which was a replica of what most Americans consume and during this period, the depressive behavior in the animals was recorded. Studies show that women between the ages of 40 to 59 are the most common users of anti-depressants. Since depression is twice as common in women as compared to men, female monkeys were chosen for this study.

This treatment regimen followed for the monkeys is similar to a human taking an antidepressant for approximately five years. After the 18 month pre-study phase was over, the monkeys were divided into two groups balanced for body weight, body mass index and depressive behavior. In the next 18 months, 21 monkeys were given sertraline in daily doses to replicate the dose typically taken by humans while the other group of 20 was given a placebo.

When MRI images were taken at the end of the treatment, it revealed that in depressed subjects the anterior cingulate cortex region of the brain was significantly increased due to the drugs. However, the volume of this region as well as the hippocampus in non-depressed subjects was decreased. Since, these areas are very much connected with other areas of the brain and affects memory, learning, spatial navigation, will, motivation, emotion, etc., – all these are also affected if a person suffers from a major depressive disorder.

Shively opined that in humans it is seen that there is a notable difference in the volume of the neural structures in depressed and non-depressed individuals. Typically it is seen that in depressed people the volume of the cingulate cortex and hippocampus is small. The reason why drugs like Zoloft can be effective in treating depression is likely because they promote neuron growth and connectivity in the affected region of the brain.

However, the problem is SSRIs such as Zoloft are not just prescribed for treating depression but also for a number of other conditions such as obsessive-compulsive disorder, bulimia, hot flashes, post-traumatic stress disorder, stroke recovery and sexual dysfunction. But, there is severe lack of researches which studies the effects of these drugs on brain volumes in individuals who are not suffering from depression.

Shivley said since the present study's findings are compelling, it is important to study the effects of SSRIs on different disorders to find out if these drugs produce similar effects in humans

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