cholecystokinin and Depressive-Disorder--Major

The placebo literature has substantially increased in 2006 and 2007, and more and more medical and psychological subspecialties have added empirical data to our knowledge.. The theoretical framework of our understanding of the placebo response needs extension to account for findings that cannot be attributed to (Pavlovian) conditioning or suggestions alone. In addition, imaging studies need to address individual responses rather than group means, and to expand beyond experimental pain research. Gender aspects have been demonstrated for the placebo response but still widely ignored, especially in neurophysiological studies. It has been shown that nocebo research needs a methodological and ethical framework that allows its exploration. Finally, analyses of clinical trial data, either as metaanalyses or as reanalyses of trial raw data, may allow us to identify factors that subsequently can be used in experimental work.. Novel findings will allow better planning of clinical drug trials, better handling of clinical trial data in the future, and finally, may eventually result in improved patient management.

Topics: Brain; Cholecystokinin; Depressive Disorder, Major; Dopamine; Humans; Placebo Effect; Positron-Emission Tomography; Receptors, Opioid, mu

Despite strong evidence of a physiologic relationship between cholecystokinin (CCK) and corticotropin-releasing hormone (CRH) in the rat central nervous system (CNS), evidence of such a relationship between the two hormones in the human CNS is lacking. A post hoc analysis of serial concentrations of immunoreactive CCK and CRH, obtained every ten minutes from CSF continuously collected over six hours, was performed. A total of 30 subjects were studied: 15 normal volunteers, 10 patients with major depression, and 5 recently-abstinent, alcohol-dependent patients. Overall, we observed an average intra-subject correlation of +.273 (P < 0.001) between CSF CRH and CCK. Inter-subject correlations between mean CSF levels of CRH and CCK were +.948 (P = 0.0001) and +.959 (P = 0.005) in the depressed and abstinent alcoholic patients, respectively. These inter-individual correlations were significantly greater than that seen within the group of normal volunteers (r = +.318, n.s.). The present data suggest that interactions between CCK and CRH are significant in the human CNS, particularly perhaps in depressed and alcoholic patients, and that CSF samples may be used to assess elements of the relationship between these hormones.

Topics: Adult; Alcoholism; Anxiety Disorders; Brain; Cholecystokinin; Corticotropin-Releasing Hormone; Depressive Disorder, Major; Humans; Temperance