The Relationship Between Plasma Cytokine Levels and Response to Selective Serotonin Reuptake Inhibitor Treatment in Children and Adolescents with Depression and/or Anxiety Disorders.
OBJECTIVE In adults there is growing evidence that antidepressant (AD) treatment results in a decline in inflammatory cytokines. This is the first report, to our knowledge, of the relationship between response to selective serotonin reuptake inhibitor (SSRI) treatment for anxiety and/or depression and cytokine levels in children and adolescents. METHODS Forty one patients who met Diagnostic and Statistical Manual for Mental Disorders, 4th ed. (DSM IV) criteria for major depressive disorder (MDD) or anxiety disorders participated in study. Their ages ranged from 9 to 18 (14.12 2.30) years. The patients were treated with fluoxetine for 8 weeks. Plasma concentrations of tumor necrosis factor (TNF) a, interleukin (IL) 6, and IL 1b were measured by enzyme linked immunosorbent assays (ELISA) before and after fluoxetine treatment. Clinical response was measured with several scales, including the Children's Depression Rating Scale Revised (CDRS R) the Beck Depression Inventory (BDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) Results: The overall response rate was 56% Antidepressant treatment significantly reduced TNF a levels (p 0.037) with no significant changes in the levels of IL 6 and IL 1b. All three proinflammatory cytokines were significantly (p 0.05) higher in SSRI refractory than in SSRI responsive patients. CONCLUSIONS Higher levels of TNF a, IL 6, and IL 1b might predict nonresponse to fluoxetine treatment in children.
Journal of child and adolescent psychopharmacology