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The clinical antidepressant effect of exogenous agmatine is not reversed by parachlorophenylalanine: a pilot study

Published online by Cambridge University Press:  26 February 2013

Baron Shopsin
Baron Shopsin*
Affiliation:
Former Chief, Unit for The Study and Treatment of Affective, Disorders, & Lithium Clinic, Neuropsychopharmacology Research Section, Department of Psychiatry, NYU Medical Center, and Associate Professor of Psychiatry, NYU School of Medicine, USA
*
Baron Shopsin, MD,PO Box 2054, Ponte Vedra Beach, Florida 32004, USA. E‐mail: [email protected]
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Abstract

Objectives

To examine and record the clinical antidepressant effect of exogenous agmatine, an amino acid derived central glutamaergic modulator in endogenously depressed subjects. It was also the author's intention to examine the effects of parachlorophenylalanine (PCPA) in therapeutic responders to determine if serotonergic mechanisms mediate agmatine's antidepressant effect.

Methodology

Exogenous agmatine was ingested in doses of 2‐3mg/day by depressed subjects with Major Depresssive Disorder (MDD), clinically assessed using the 21 item Hamilton Rating Scale for Depression (HAM‐D), the Clinical Global Impression (CGI) and the Brief Psychiatric Rating Scale (BPRS). Antidepressant responders volunteered to concommittantly ingest parachlorophenylalanine (PCPA) at starting doses of 250mg/day, and increased until depressive relapse, mitigating side effects, or a maximum dosage of 1250mg/day.

Results

Three depressed subjects showing total illness remission with exogenous agmatine did not relapse after concomitantly adding PCPA. Effective in relieving both psychomotor agitation and retardation, the antidepressant effect was free of physical or behavioural side effects: gastrointestinal discomfort and loose stools in one subject resolved spontaneously within days. All three subjects refused to risk depressive relapse by temporarily stopping agmatine after PCPA was stopped.

Conclusion

The antidepressant effect of exogenous agmatine was documented in a small number of MDD subjects, and was not reversed/modified by PCPA confirming findings in animals that therapeutic response is not mediated by serotonergic mechanisms. A NAMDA (N‐methyl‐D‐aspartate) receptor antagonist, agmatine's recognized function in brain as inhibitory modulator of excitatory glutamatergic transmission suggests a pivotal role for brain glutamate, contributing to the ripening glutamatergic basis of depression, and a rational basis for future antidepressant pharmacotherapy.

Keywords

agmatineantidepressantastrocyteglutamatergicN-methyl-D-aspartateparachlorophenylalanineSerotonergic
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 25 , Issue 2 , April 2013 , pp. 113 - 118
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013

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Footnotes

He remains clinically active and maintains a private practice.

[Correction added on 2 August 2012, after first online publication: The affiliation was updated to indicate that the author is the former chief of the stated affiliation and an associate professor of psychiatry who currently remains clinically active with a private practice.]

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