[Monoaminergic function in major depression. A possibly helpful tool for choosing treatment strategy]

Little is known about the variables that might predict outcome in major depression. Most studies do not imply any clinical consequences for treatment because their predictors were nonspecific and results did not differ between the different treatment options. Finding a variable that can predict the antidepressive treatment option best suited to an individual might help in reducing the considerable number of nonresponders in the treatment of depression. As most antidepressants influence the serotonergic or noradrenergic system, monoaminergic function at the start of therapy might be a possible specific response predictor. In this review, measures that can determine monoaminergic function are presented along with their relationship to treatment response, e.g., monoaminergic metabolites, neuroendocrine challenge tests, evoked event-related potentials, genetics, and neuroimaging. In conclusion, the results of serotonergic functions are still heterogeneous, but the relationship between noradrenergic function and treatment response has not been investigated in any detail yet.