I would like to comment on several critical aspects of the January 2008 article of Barton and colleagues1 entitled “Elevated Brain Serotonin Turnover in Patients With Depression: Effect of Genotype and Therapy.”
The authors indicate that measured internal jugular venoarterial (VA) differences in plasma levels of 5-hydroxyindoleacetic acid (5-HIAA, the major serotonin metabolite) are proportionally related to brain serotonin turnover. It is difficult to reconcile this view with the fact that observed individual VA differences were often quite close to or less than zero. Thus, the standard deviations observed for baseline VA gradients in both the major depressive disorder and control groups were similar to or greater than the means, and 6 of 11 patients with major depressive disorder appeared to have no VA gradient after selective serotonin reuptake inhibitor (SSRI) treatment. It seems inconceivable that a substantial fraction of subjects has little or no brain serotonin turnover and that others have many-fold higher rates of turnover. Even putting aside those subjects with zero or negative VA differences, there is a tremendous interindividual range that is inconsistent with the underlying physiological process that is purportedly indexed.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Thank you for submitting a comment on this article. It will be reviewed by JAMA Psychiatry editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.