Depressive symptoms, monoamines levels, MAO-B activity and effect of treatment in a subset of depressed individuals from government sector hospital at Karachi.

Depression is one of the leading causes of disability in developing countries including Pakistan. This study was designed to assess the frequency and severity of depressive symptoms, monoamines and their metabolite levels, MAO-B activities before and after treatment with antidepressants in a sub-set of Karachi population in Pakistan. Drug naive depressed subjects were evaluated before and after treatment with selective serotonin reuptake inhibitors. Symptoms of depressed mood and anxiety psychic (90%) were more frequent whereas, suicidal thoughts (~50%) and feelings of guilt (~30%) were less common. Hamilton Depression Rating Scale scores were 21.4 ± 0.8 in both genders with a significantly higher score (1.3x) in females. Homovanillic acid, 5- hydroxyindoleacetic acid and MAO-B activity were significantly higher 43%, 66% and 25% respectively, in depressed than normal subjects. A significant decline after 2 weeks treatment in HDRS scores with fluoxetine (19%) and paroxetine (40%) and in MAO-B activity (20%) was observed. In conclusion, in our population early decline in HDRS scores supports that they are SSRIs responders, whereas a concomitant reduction in MAO-B activities indicates that it can be considered as one of the parameters for early detection of response. Additionally, the low frequency of suicidal thoughts could be associated with higher levels of monoamine metabolites.