Compounds containing cytosolic choline in the basal ganglia: A potential biological marker of true drug response to fluoxetine

Shamsah B. Sonawalla, Perry F. Renshaw, Constance M. Moore, Jonathan E. Alpert, Andrew A. Nierenberg, Jerrold F. Rosenbaum, Maurizio Fava

Research output: Contribution to journalArticle

57 Scopus citations


Objective: Studies have identified two types of antidepressant response: true drug response and placebo pattern response. This study examined the relationship between true drug response and choline-creatine ratios in the basal ganglia of depressed patients treated with fluoxetine. Method: The authors evaluated drug-free outpatients with major depression before (N=41) and after (N=15) 8 weeks of fluoxetine treatment, 20 mg/day, by using proton magnetic resonance spectroscopy. Results: There was a significant difference in the degree of change from baseline to week 8 in choline-creatine ratios between the true drug response group (N=8) and the placebo pattern response/nonresponse group (N=7); the true drug response patients had a 20% increase in choline-creatine ratios, and the placebo pattern response/nonresponse patients had a 12% decrease in choline-creatine ratios. Conclusions: These data suggest that true drug response to fluoxetine treatment in depression may be associated with an increase in choline- creatine ratios in the basal ganglia.

Original languageEnglish (US)
Pages (from-to)1638-1640
Number of pages3
JournalAmerican Journal of Psychiatry
Issue number10
StatePublished - Oct 1999
Externally publishedYes


ASJC Scopus subject areas

  • Psychiatry and Mental health

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