Depression

Unipolar Depression DSM - IV Criteria (5 or more symptoms over a 2 week period) depressed mood diminished interest or pleasure (anhedonia) weight or appetite increase or decrease sleeping too much or too little feeling very agitated or physically slowed loss of energy feelings of worthlessness or guilt difficulty concentrating or making decisions thoughts of death or suicide

Population Frequency  9-26% females lifetime will get uni- polar depression  5-12% males will get uni-polar depression  for both m/f only 1 % will come down with Bipolar disorder.

Left frontal lobe = approach/joy approach/joy Right frontal lobe = withdrawal/distress withdrawal/distress Underactive left frontal EEG in adults and in children Unipolar Depression continued

 Children of depressed mothers: Frontal EEG activity during play at one year of age Left about equal to right Left about equal to right  Children of non-depressed mothers: left greater than right left greater than right University of Washington Research (Dr. Dawson)

Unipolar Depression  Low levels of norepinephrine, dopamine, and serotonin  Biochemical treatments raise these neurotransmitters  amino acids: phenylalanine and or tyrosine can raise dopamine and norepinephrine  Tryptophan can raise serotonin  SAM-e (S-Adenosyl Methionine) can increase dopamine and epinephrine can increase dopamine and epinephrine

Unipolar Depression  MAO inhibitors raise both norepinephrine and serotonin  SSRI’s (Selective Serotonin Reuptate Inhibitors) raises sertonin (e.g., prozac, paxil, zoloft)

Efficacy and Tolerability of Ze 117 St. John’s Wort Extract in Comparison with Placebo, Imipramine and Fluoxetine for the Treatment of Mild to Moderate Depression according to ICD-10. An Overview. R. Käufeler, B. Meier, A. Brattström Volume 34; Suppl1: S49-S

St. John’s Wort Extract Ze 117 (Hypericum perforatum) Inhibits Norepinephrine and Serotonin Uptake into Rat Brain Slices and Reduces ß-Adrenoceptor Numbers on Cultured Rat Brain Cells U. Kientsch, S. Bürgi, C. Ruedeberg, S. Probst, U.E. Honegger Volume 34; Suppl1: S56-S