TY - JOUR
T1 - Cytokines plasma levels during antidepressant treatment with sertraline and transcranial direct current stimulation (tDCS)
T2 - Results from a factorial, randomized, controlled trial
AU - Brunoni, André R.
AU - Machado-Vieira, Rodrigo
AU - Zarate, Carlos A.
AU - Valiengo, Leandro
AU - Vieira, Erica Lm
AU - Benseñor, Isabela M.
AU - Lotufo, Paulo A.
AU - Gattaz, Wagner F.
AU - Teixeira, Antonio L.
PY - 2014/4
Y1 - 2014/4
N2 - Rationale: The inflammatory hypothesis of depression states that increased levels of pro-inflammatory cytokines triggered by external and internal stressors are correlated to the acute depressive state. This hypothesis also suggests that pharmacotherapy partly acts in depression through anti-inflammatory effects. Transcranial direct current stimulation (tDCS) is a novel, promising, non-invasive somatic treatment for depression, although its antidepressant mechanisms are only partly understood. Objectives: We explored the effects of tDCS and sertraline over the immune system during an antidepressant treatment trial. Methods: In a 6-week, double-blind, placebo-controlled trial, 73 antidepressant-free patients with unipolar depression were randomized to active/sham tDCS and sertraline/placebo (2 × 2 design). Plasma levels of several cytokines (IL-2, IL-4, IL-6, IL-10, IL-17a, IFN-γ, and TNF-α) were determined to investigate the effects of the interventions and of clinical response on them. Results: All cytokines, except TNF-α, decreased over time, these effects being similar across the different intervention-groups and in responders vs. non-responders. Conclusions: tDCS and sertraline (separately and combined) acute antidepressant effects might not specifically involve normalization of the immune system. In addition, being one of the first placebo-controlled trials measuring cytokines over an antidepressant treatment course, our study showed that the decrease in cytokine levels during the acute depressive episode could involve a placebo effect, highlighting the need of further placebo-controlled trials and observational studies examining cytokine changes during depression treatment and also after remission of the acute depressive episode.
AB - Rationale: The inflammatory hypothesis of depression states that increased levels of pro-inflammatory cytokines triggered by external and internal stressors are correlated to the acute depressive state. This hypothesis also suggests that pharmacotherapy partly acts in depression through anti-inflammatory effects. Transcranial direct current stimulation (tDCS) is a novel, promising, non-invasive somatic treatment for depression, although its antidepressant mechanisms are only partly understood. Objectives: We explored the effects of tDCS and sertraline over the immune system during an antidepressant treatment trial. Methods: In a 6-week, double-blind, placebo-controlled trial, 73 antidepressant-free patients with unipolar depression were randomized to active/sham tDCS and sertraline/placebo (2 × 2 design). Plasma levels of several cytokines (IL-2, IL-4, IL-6, IL-10, IL-17a, IFN-γ, and TNF-α) were determined to investigate the effects of the interventions and of clinical response on them. Results: All cytokines, except TNF-α, decreased over time, these effects being similar across the different intervention-groups and in responders vs. non-responders. Conclusions: tDCS and sertraline (separately and combined) acute antidepressant effects might not specifically involve normalization of the immune system. In addition, being one of the first placebo-controlled trials measuring cytokines over an antidepressant treatment course, our study showed that the decrease in cytokine levels during the acute depressive episode could involve a placebo effect, highlighting the need of further placebo-controlled trials and observational studies examining cytokine changes during depression treatment and also after remission of the acute depressive episode.
KW - Controlled trial
KW - Cytokines
KW - Interleukins
KW - Major depressive disorder
KW - Placebo effect
KW - Placebo response
KW - Randomized
KW - Sertraline
KW - Transcranial direct current stimulation
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U2 - 10.1007/s00213-013-3322-3
DO - 10.1007/s00213-013-3322-3
M3 - Article
C2 - 24150249
AN - SCOPUS:84896490306
SN - 0033-3158
VL - 231
SP - 1315
EP - 1323
JO - Psychopharmacology
JF - Psychopharmacology
IS - 7
ER -