Cytokine production and treatment response in major depressive disorder

Neuropsychopharmacology. 2000 Apr;22(4):370-9. doi: 10.1016/S0893-133X(99)00134-7.


In a controlled study, such immunological parameters as whole blood production of the cytokines interleukin-6 (IL-6) and tumor-necrosis factor-alpha (TNF-alpha) were assessed in 24 inpatients with a major depressive disorder (MDD) both before and again under treatment. After a 6-week treatment period with amitriptyline, patients were classified as responders or nonresponders according to their psychopathological outcome as evaluated by the Hamilton and the Montgomery-Asberg Depression Rating Scales. Pre-treatment levels of c-reactive protein (CRP) were significantly higher in both patient subgroups than in the control subjects. In comparison to the controls, unstimulated pretreatment production of IL-6 was significantly decreased in the responders; whereas it was significantly increased in the nonresponder subgroup. Post-treatment values did not differ significantly among the patient and control groups. Pretreatment levels of TNF-alpha were increased in both patient subgroups, with a significant decrease during treatment only in the responder subgroup. Pretreatment levels of IL-6/10(5) mononuclear cells and the ratio between lymphocytes and monocytes acted as independent variables with regard to the clinical response. Our data indicate that unstimulated secretion of TNF-alpha is related to the psychopathological improvement; whereas, IL-6 levels might dichotomize the patients into subsequent responders and nonresponders already at admission.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amitriptyline / administration & dosage
  • Antidepressive Agents, Tricyclic / administration & dosage
  • Cell Count
  • Cytokines / biosynthesis
  • Cytokines / blood*
  • Depressive Disorder / blood*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Interleukin-6 / blood
  • Lymphocyte Count / drug effects
  • Male
  • Middle Aged
  • Monocytes / drug effects
  • Regression Analysis
  • Tumor Necrosis Factor-alpha / metabolism


  • Antidepressive Agents, Tricyclic
  • Cytokines
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Amitriptyline