Pharmacopsychiatry 2008; 41(1): 37-39
DOI: 10.1055/s-2007-993208
Letter

© Georg Thieme Verlag KG Stuttgart · New York

Novel Augmentation Therapy with Cilostazol for the Geriatric Major Depressive Disorder Patient with Deep White Matter Hyperintensities on T2-Weighted Brain MRI: A Case Report

K. Takahashi 1 , A. Oshima 1 , K. Inoue 2 , H. Takeyoshi 1 , M. Fukuda 1 , M. Mikuni 1
  • 1Department of Psychiatry and Human Behavior, Gunma University Graduate School of Medicine, Gunma, Japan
  • 2Gunma Prefectural Psychiatric Medical Center, Gunma, Japan
Further Information

Publication History

received 29.06.2007 revised 24.08.2007

accepted 03.09.2007

Publication Date:
18 January 2008 (online)

Abstract

In our search of a new augmentation therapy for geriatric patients with intractable depression, we administered cilostazol, an antiplatelet agent, in addition to conventional antidepressants to a patient with persistent major depressive disorder showing deep white matter hyperintensities on a T2-weighted magnetic resonance image and evaluated cerebral blood flow before and after the administration of cilostazol by 99mTc-ethyl-cysteinate dimer single photon emission computed tomography. This patient showed improvements of depressive symptoms as well as an increase in cerebral blood flow. These findings suggest a potential efficacy of cilostazol as a new drug for use in augmentation therapy for depressed patients with deep white matter hyperintensities.

References

  • 1 Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M. Vascular depression hypothesis.  Arch Gen Psychiatry. 1997;  54 915-922
  • 2 Gotoh F, Tohgi H, Hirai S, Terashi A, Fukuuchi Y, Otomo E, Shinohara Y, Itoh E, Matsuda T, Sawada T, Yamaguchi T, Nishimaru K, Ohashi Y. Cilostazol Stroke prevention study: A placebo-controlled double-blind trial for secondary prevention of cerebral infarction.  J Stroke Cerebrovasc Dis. 2000;  9 147-157
  • 3 Kales HC, Maixner DF, Mellow AM. Cerebrovascular disease and late-life depression.  Am J Geriatr Psychiatry. 2005;  13 88-98
  • 4 Kimura Y, Tani T, Kanbe T, Watanabe K. Effect of cilostazol on platelet aggregation and experimental thrombosis.  Arzneimittelforschung. 1985;  35 1144-1149
  • 5 Krishnan KR, Goli V, Ellinwood EH, France RD, Blazer DG, Nemeroff CB. Leukoencephalopathy in patients diagnosed as major depressive.  Biol Psychiatry. 1988;  23 519-552
  • 6 Krishnan KR, Hays JC, Blazer DG. MRI-defined vascular depression.  Am J Psychiatry. 1997;  154 497-501
  • 7 Mochizuki Y, Oishi M, Mizutani T. Effects of cilostazol on cerebral blood flow, P300, and serum lipid levels in the chronic stage of cerebral infarction.  J Stroke Cerebrovasc Dis. 2001;  10 63-69
  • 8 Nakane Y, Williams JBW. Japanese version of structured interview guide for the Hamilton Depression Rating Scale (SIGH-D).  Jpn J Clin Psychopharmacol. 2003;  6 1353-1368
  • 9 Nibuya M, Morinobu S, Duman RS. Regulation of BDNF and trkB mRNA in rat brain by chronic electroconvulsive seizure and antidepressant drug treatments.  J Neurosci. 1995;  15 7539-7547
  • 10 Nibuya M, Nestler EJ, Duman RS. Chronic antidepressant administration increases the expression of cAMP response element binding protein (CREB) in rat hippocampus.  J Neurosci. 1996;  16 2365-2372
  • 11 Tanaka T, Ishikawa T, Hagiwara M, Onoda K, Itoh H, Hidaka H. Effects of cilostazol, a selective cAMP phosphodiesterase inhibitor on the contraction of vascular smooth muscle.  Pharmacology. 1988;  36 313-320
  • 12 Watanabe T, Zhang N, Liu M, Tanaka R, Mizuno Y, Urabe T. Cilostazol protects against brain white matter damage and cognitive impairment in a rat model of chronic cerebral hypoperfusion.  Stroke. 2006;  37 1539-1545

Correspondence

K. TakahashiMD, PhD 

3-39-22 Showa-machi

Maebashi

371-8511 Gunma

Japan

Phone: +81/27/220 81 90

Fax: +81/27/220 81 87

Email: tkeisuke@showa.gunma-u.ac.jp