Tuesday 17 July 2018

Elevated inflammatory markers inhibit the effect of antidepressants

Elevated inflammatory markers inhibit the effect of antidepressants
Not all depressed patients benefit from antidepressants. Research has now shown that elevated inflammatory markers are found in the blood of these patients. It may make more sense to treat this inflammation in these patients. 

A third of people who suffer from depression do not respond to the medication that is available today. A study at the Emory University reveals that resistance to treatment with antidepressants is associated with elevated inflammatory markers. 
Past studies involving laboratory animals have already shown that inflammation has an effect on the brain, which undermines the effectiveness of conventional  antidepressants. This is one of the first studies involving people that confirms these results. The results were published in the journal Psychoneuroendocrinology. [1]

Elevation of TNF, IL-6 and CRP

In the study, the blood was tested of 98 depressed patients who were not taking any medication at that point in time, but who had received various antidepressant treatments in the past. It turned out that the blood tests showed that these patients, in whom the medication had not worked two or three times, had significant elevations in their blood of the inflammatory cytokines TNF, sTNR-R2 and IL-6. In these patients, the CRP level was also higher, but that only applied when obesity was not included in the statistical analysis, because obesity and CRP are very interlinked. 
A researcher states that if a patient has a high CRP value (CRP > 3mg/l), it might be the case that medication that influences the neurotransmitter dopamine is more effective than conventional drugs that influence the neurotransmitter serotonin. [2] An inflammation can also often be reduced by lifestyle adjustments, i.e. a healthy diet, weight loss and more exercise. In addition, the initial tests with anti-inflammatory medication show promising results, but follow-up research is needed to substantiate this further.

Have the inflammatory markers measured

In the US, approximately 10 percent of adults suffer from depression. And globally this is one of the main culprits of (occupational) incapacity. The researchers say that the main conclusion from this study is perhaps that, for depressed patients who do not benefit from medication, it may be worthwhile asking their practitioner to arrange for their inflammatory markers to be measured and to tackle the inflammation– or the effects of this on the brain. 


[1] Antidepressant treatment resistance is associated with increased inflammatory markers in patients with major depressive disorder, Ebrahim Haroon, Alexander W. Daguanno, Bobbi J. Woolwine, David R. Goldsmith, Wendy M. Baer, Evanthia C. Wommack, Jennifer C. Felger, Andrew H. Miller, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, United States