By Elaine Carey
The Toronto Star
January 9, 2004
http://thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1073603407975&call_pageid=968867505381&col=969048872038
Training patients to tune out the signals that cause major depression
alters the chemicals in the brain as much as drugs do, a new study has found.
While the treatment -- called cognitive behaviour therapy -- changes
different brain chemicals than drugs do, the overall effect is the same,
says the study, led by the Rotman Research Institute at the Baycrest Centre
for Geriatric Care.
The study, published this week in the Archives of General Psychiatry, is
the first to show how therapy changes the chemical balance in the brain,
said Dr. Helen Mayberg, a senior scientist at the Rotman Institute.
The researchers found that therapy targets many of the same brain regions
as drug treatment but in different directions.
It may help doctors better understand why a particular treatment might work
for one patient and not another, she said in an interview.
Patients with clinical depression are commonly treated with drugs or
therapy or a combination of both, but now have to go through a trial and
error period until the best treatment with the fewest side effects is found.
"The way people are treated now depends on how they come to treatment,"
Mayberg said.
"If they go to a general practitioner, they probably get drugs because it's
hard work to do therapy. It requires a major time commitment.
"But on the other hand, if your brain might best respond to therapy, who
wants to take drugs if they don't have to?
"We want to get to the point where people get what's best for them," she
said. "This is just the first step."
The study used positron emission tomography (PET) to pinpoint where maximum
changes in brain metabolism occur.
In the study, 14 clinically depressed adults underwent 15 to 20 cognitive
therapy sessions. Their brains were scanned before they began treatment and
at the end of the therapy.
It found that as patients in therapy learn to turn off the thinking that
leads them to dwell on negative thoughts and attitudes, the chemical
activity in certain parts of the brain decreases as well.
Brain scans may one day become a useful part of treatment for clinically
depressed patients, Mayberg said, helping doctors to decide in advance what
would be the most effective treatment and to monitor its effectiveness.
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