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Depression, Borna disease, and amantadine

1997; Elsevier BV; Volume: 349; Issue: 9056 Linguagem: Inglês

10.1016/s0140-6736(05)62741-9

1474-547X

Klaus Lieb, Frank T. Hufert, Karl Bechter, Joachim Bauer, Johannes Kornhuber,

Influenza Virus Research Studies

Bode and colleagues (Jan 18, p 178)1Bode L Dietrich DE Stoyloff R Emrich HM Ludwig H Amantadine and human Borna disease virus in vitro in an infected patient with bipolar depression.Lancet. 1997; 349: 178-179Summary Full Text Full Text PDF PubMed Scopus (74) Google Scholar do not mention that the antidepressant effect of amantadine in patients with a depressive syndrome is well known in clinical psychiatry. The antidepressant activity of amantadine can be explained by its action on specific central neurotransmitter systems. Amantadine is a non-competitive N-methyl-D-aspartate (NMDA)-type glutamate receptor antagonist that also binds to the sigma-receptor and the nicotinic acetylcholine-receptor.2Kornhuber J Weller M Schoppmeyer K Riederer P Amantadine and memantine are NMDA receptor antagonists with neuroprotective properties.J Neural Transm Suppl. 1994; 43: 91-104PubMed Google Scholar The hypothesis of Bode and colleagues1Bode L Dietrich DE Stoyloff R Emrich HM Ludwig H Amantadine and human Borna disease virus in vitro in an infected patient with bipolar depression.Lancet. 1997; 349: 178-179Summary Full Text Full Text PDF PubMed Scopus (74) Google Scholar that the antidepressant activity of amantadine results from its antiviral efficacy against Borna disease virus (BDV) is challenged by a study that showed antidepressant activity for a range of NMDA receptor antagonists independently of BDV-infection in an animal model of depression.3Moryl E Danysz W Quack G Potential antidepressive properties of amantadine, memantine and bifemelane.Pharmacol Toxicol. 1993; 72: 394-397Crossref PubMed Scopus (165) Google Scholar The detection of BDV by reverse-transcriptase PCR in peripheral blood of psychiatric patients is questionable. Although Bode and colleagues4Bode L Dürrwald R Rantam FA Ferszt R Ludwig H First isolates of infectious human Borna disease virus from patients with mood disorders.Mol Psychiatry. 1996; 1: 200-212PubMed Google Scholar reported BDV in the peripheral blood of up to 50% of psychiatric patients, we and others did not detect the virus in the blood of a larger sample of psychiatric patients from areas where BDV is endemic in horses and sheep.5Bechter K Herzog S Schüttler R Borna disease virus–possible cause of human neuropsychiatric disorders.Neurol Psychiatr Brain Res. 1996; 4: 45-52Google Scholar Furthermore, Bode and colleagues4Bode L Dürrwald R Rantam FA Ferszt R Ludwig H First isolates of infectious human Borna disease virus from patients with mood disorders.Mol Psychiatry. 1996; 1: 200-212PubMed Google Scholar described two patients with bipolar depressive disorder, in whom BDV antigen disappeared 43 and 55 days, respectively, after antidepressant treatment without any use of amantadine. This finding suggests that BDV may be cleared spontaneously from peripheral blood. Thus, although amantadine may have the potential to inhibit BDV in vitro, its effectiveness as an antidepressant drug may solely result from its antagonistic action on NMDA receptors.