Variations in circulating cytokine levels during 52 week course of treatment with SSRI for major depressive disorder

Eur Neuropsychopharmacol. 2008 Dec;18(12):917-24. doi: 10.1016/j.euroneuro.2008.08.001. Epub 2008 Sep 20.

Abstract

Major depressive disorder (MDD) is a psychiatric condition characterized by hypercortisolism and variations in circulatory cytokines. Previously it has been reported that administration of selective serotonin reuptake inhibitors (SSRI) in MDD patients modify cortisol and cytokine levels but these studies only evaluated changes over a short time period. This work reports the long-term effects of administration of SSRI on the cortisol levels and pro-/anti-inflammatory cytokine profile in a group of MDD patients treated for 52 weeks. A total of 31 patients diagnosed with MDD received anti depressant treatment with SSRI. HDRS and BDI were administered over a year, and levels of interleukin IL-1beta, IL-10, IL-2, IFN-gamma, IL-4, IL-13, and 24-h urine cortisol were determined at weeks (W) 0, 5, 20, 36 and 52 of treatment. Before treatment we found high levels of cortisol, IL-4, IL-13 (Th2) and IL-10 in MDD patients when compared with healthy volunteers. At W20 psychiatric scales indicated a remission of the depressive episode concomitantly with increments in IL-2 and IL-1beta but without changes in cortisol. Towards the end of the treatment (W52) we observed a significant reduction (p<0.01) in cortisol levels, with an increment in IL-1beta and IFN-gamma and a decrease in Th2 cytokines. Our results suggest that depressed patients only reach a partial reestablishment of HPA axis function after the long-term administration of SSRI.

Publication types

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

MeSH terms

  • Adult
  • Analysis of Variance
  • Antidepressive Agents / therapeutic use*
  • Cytokines / blood*
  • Depressive Disorder, Major / blood*
  • Depressive Disorder, Major / drug therapy*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Hydrocortisone / blood
  • Longitudinal Studies
  • Male
  • Psychiatric Status Rating Scales
  • Radioimmunoassay / methods
  • Retrospective Studies
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Time Factors
  • Young Adult

Substances

  • Antidepressive Agents
  • Cytokines
  • Serotonin Uptake Inhibitors
  • Hydrocortisone