Effects of Antidepressant Therapy on Brain Dopamine Transporter Activity in People With Major Depression

Inclusion Criteria

• DSM-IV diagnosis of major depressive episode (MDE) or major depressive disorder (MDD)
• Drug free of psychotropic medication for more than 6 months before study entry
• 17-item Hamilton Depression Scale (HAM-D17) score of greater than 16
• Woman of childbearing age with a negative pregnancy test within 48 hours of study entry
• Absence of DSM-IV Axis I diagnosis as determined by Structured Clinical Interview for DSM Disorders (SCID)

Exclusion Criteria

• DSM-IV Axis I diagnosis other than MDE
• History of mania
• Current alcohol or drug abuse, or alcohol or drug dependence within 6 months before study entry
• History of sensitivity or intolerance to s-citalopram
• Medical contraindication to the use of s-citalopram
• Unstable medical condition (e.g., angina pectoris, untreated hypertension)
• Pregnant or breastfeeding
• Woman of childbearing potential not using a medically acceptable form of birth control
• Actively suicidal or requiring hospitalization
• Requiring additional psychotropic drug therapy
• History of transient ischemic attacks
• History of cerebral infarction (including lacunar infarct with symptoms that last more than 24 hours)
• History of Binswanger's disease (or a history of hypertensive encephalopathy)
• History of intracranial hemorrhage
• History of head trauma with loss of consciousness
• History of encephalitis
• History of extended exposure to known neurotoxin (e.g., cyanide, carbon monoxide)
• Uncontrolled metabolic disorder (e.g., thyroid disease, diabetes mellitus)
• History of cognitive impairment other than MDE
• History of normal pressure hydrocephalus
• History of cancer metastatic to the central nervous system
• History of Parkinson's disease or other basal ganglia disease
• History of Guillain-Barre syndrome (chronic or relapsing polyneuropathy)
• Inability to undergo an MRI scan
• History of DSM-IV Axis I Mood Disorder