Complications in major depressive disorder therapy: A review of magnetic resonance spectroscopy studies

Eduardo Caverzasi, Anna Pichiecchio, Alessandro Calligaro, Moreno Pasin, Elisabetta Giugni, Massimo Pasquini, Massimo Biondi, Francesco Barale, Stefano Bastianello

Research output: Contribution to journalArticlepeer-review


Advanced magnetic resonance imaging techniques, such as proton magnetic resonance spectroscopy (H-MRS), have helped to further understanding of the pathophysi-ology of major depressive disorder (MDD) and to shed light on mechanisms underlying the therapeutic response. Potential complications of MDD therapy constitute an important area of research. Interruption of the absorption of serotonin reuptake inhibitors (SSRIs) is associated with discontinuation syndrome, while electrocon-vulsive therapy (ECT) can lead to transient and persistent anterograde amnesia. This paper reviews studies, since 1994, that have used H-MRS to evaluate adverse effects and complications of MDD treatment, either with ECT or SSRIs. Three articles have been published on adverse effects and complications of MDD treatment and H-MRS. Two focused on the ECT-induced memory deterioration and showed no sign of hippocampal atrophy in MDD patients with a residual memory deterioration after ECT, but a significant mean increase of the signal from Cho-containing compounds bilaterally, possibly due to an alteration of membrane turnover in the hip-pocampal region. The third paper showed that placebo-day Cho/Cr metabolite ratios were decreased in subjects with discontinuation syndrome, a finding that possibly reflects the dynamics of rostral anterior cingulate function. In spite of the limits deriving from the small number of papers published, our review demonstrated that H-MRS could be a useful instrument not only in evaluating therapy efficacy, but also for offering new insights into mechanisms underlying MDD treatments.

Original languageEnglish
Pages (from-to)129-132
Number of pages4
JournalFunctional Neurology
Issue number3
Publication statusPublished - Jul 2008


  • Advanced MRI technique
  • Major depression disorder
  • Spectroscopy
  • Therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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