Higher serotonin transporter availability in early‐onset obsessive–compulsive disorder patients undergoing escitalopram treatment: A [11C]DASB PET study |
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| Authors: | Junhee Lee Bo‐Hyung Kim Euitae Kim Oliver D Howes Kang Ik Kevin Cho Youngwoo Bryan Yoon Jun Soo Kwon |
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| Institution: | 1. Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea;2. Department of Clinical Pharmacology and Therapeutics, College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea;3. Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea;4. Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Gyeonggi‐do, Republic of Korea;5. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK;6. MRC Clinical Sciences Centre, London, UK;7. Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK;8. Institute of Human Behavioral Medicine, SNU‐MRC, Seoul, Republic of Korea;9. Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea |
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| Abstract: | Objective Early‐onset obsessive–compulsive disorder (EOCD) and late‐onset obsessive–compulsive disorder (LOCD) are distinct subtypes of obsessive–compulsive disorder (OCD). OCD patients are treated with serotonin reuptake inhibitors, but the difference in serotonin transporter (SERT) availability between medicated EOCD and LOCD is unexplored yet. Methods Six EOCD and 6 LOCD patients were enrolled. They underwent serial 11C]DASB positron emission tomography scans during maintenance therapy with escitalopram, and their plasma concentration of escitalopram was measured simultaneously with the scan. Then, the drug‐free binding potential of SERT was calculated by pharmacokinetic–pharmacodynamic modelling. Results In comparison with LOCD patients, SERT availability was significantly higher in the putamen of EOCD patients (U = 4, p = .026), but not in the caudate nucleus (U = 14, p = .589), thalamus (U = 16, p = .818), and dorsal raphe nucleus (U = 7, p = .093). Binding potential of putamen showed a negative correlation (r = ?.580, p = .048) with age of onset of the disease, but not with the Yale–Brown Obsessive Compulsive Scale scores. Conclusions These findings indicate that the earlier the age of onset of OCD, the less serotonergic pathology there is and that this difference remains even after long‐term serotonin reuptake inhibitor treatment. Clinically, it might suggest that nonserotonergic treatments would be a better option for EOCD patients. |
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| Keywords: | [11C]DASB PET age of onset escitalopram obsessive– compulsive disorder serotonin transporter |
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