Changes in interleukin-6 levels during electroconvulsive therapy may reflect the therapeutic response in major depression

Acta Psychiatr Scand. 2017 Jan;135(1):87-92. doi: 10.1111/acps.12665. Epub 2016 Nov 14.


Objective: Interleukin-6 (IL-6) has been reported to be elevated in major depressive disorder (MDD) but decreased by antidepressive medication. IL-6 levels are markedly elevated both after epileptic seizures and single electroconvulsive therapy (ECT) session, but long-term changes in IL-6 levels after ECT have not been studied. The correlation between immediate and long-term changes in proinflammatory cytokines and outcome after ECT was investigated.

Method: Thirty patients suffering from MDD participated in the study. IL-6, interleukin-1β (IL-1β) and interleukin-1 receptor antagonist (IL-1RA) levels were examined at baseline and at 2 and 4 h after the first, fifth and the last ECT sessions. The response to ECT was measured with Montgomery-Åsberg Depression Rating Scale (MADRS).

Results: ECT repeatedly caused an increase in IL-6 levels at the 4-h time point. However, the baseline IL-6 levels decreased among remitters, but not among non-remitters, towards the end of ECT. IL-1β levels were mostly below detectable level, and IL-1Ra levels did not change during and after ECT.

Conclusion: ECT has distinct acute and long-term effects on IL-6 levels. Interestingly, the long-term effect of ECT on IL-6 seems to correlate with outcome, providing further evidence of the mechanism of action of ECT and supporting the inflammation theory in MDD.

Keywords: cytokine; electroconvulsive therapy; major depressive disorder; seizure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Depressive Disorder, Major / therapy*
  • Electroconvulsive Therapy / methods*
  • Female
  • Humans
  • Interleukin 1 Receptor Antagonist Protein / metabolism
  • Interleukin-1beta / metabolism
  • Interleukin-6 / immunology
  • Interleukin-6 / metabolism*
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome


  • IL1B protein, human
  • IL1RN protein, human
  • IL6 protein, human
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1beta
  • Interleukin-6