Cytokines plasma levels during antidepressant treatment with sertraline and transcranial direct current stimulation (tDCS): Results from a factorial, randomized, controlled trial

André R. Brunoni, Rodrigo Machado-Vieira, Carlos A. Zarate, Leandro Valiengo, Erica Lm Vieira, Isabela M. Benseñor, Paulo A. Lotufo, Wagner F. Gattaz, Antonio L. Teixeira

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1315-1323
Number of pages9
JournalPsychopharmacology
Volume231
Issue number7
DOIs
StatePublished - Apr 2014
Externally publishedYes

Keywords

  • Controlled trial
  • Cytokines
  • Interleukins
  • Major depressive disorder
  • Placebo effect
  • Placebo response
  • Randomized
  • Sertraline
  • Transcranial direct current stimulation

ASJC Scopus subject areas

  • Pharmacology

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