Revisiting the monoamine hypothesis of depression: a new perspective.

Published online

Journal Article

As the incidence of depression increases, depression continues to inflict additional suffering to individuals and societies and better therapies are needed. Based on magnetic resonance spectroscopy and laboratory findings, gamma aminobutyric acid (GABA) may be intimately involved in the pathophysiology of depression. The isoelectric point of GABA (pI = 7.3) closely approximates the pH of cerebral spinal fluid (CSF). This may not be a trivial observation as it may explain preliminary spectrophotometric, enzymatic, and HPLC data that monoamine oxidase (MAO) deaminates GABA. Although MAO is known to deaminate substrates such as catecholamines, indoleamines, and long chain aliphatic amines all of which contain a lipophilic moiety, there is very good evidence to predict that a low concentration of a very lipophilic microspecies of GABA is present when GABA pI = pH as in the CSF. Inhibiting deamination of this microspecies of GABA could explain the well-established successful treatment of refractory depression with MAO inhibitors (MAOI) when other antidepressants that target exclusively levels of monoamines fail. If further experimental work can confirm these preliminary findings, physicians may consider revisiting the use of MAOI for the treatment of non-intractable depression because the potential benefits of increasing GABA as well as the monoamines may outweigh the risks associated with MAOI therapy.

Full Text

Duke Authors

Cited Authors

  • Goldberg, JS; Bell, CE; Pollard, DA

Published Date

  • 2014

Published In

Volume / Issue

  • 6 /

Start / End Page

  • 1 - 8

PubMed ID

  • 24737931

Pubmed Central ID

  • 24737931

International Standard Serial Number (ISSN)

  • 1177-391X

Digital Object Identifier (DOI)

  • 10.4137/PMC.S11375

Language

  • eng

Conference Location

  • United States