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children and adolescent, SSRI, cytokines, depression, anxiety
Abstract:
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 (14.122.30) years. The patients were treated with
fluoxetine for 8 weeks. Plasma concentrations of tumor necrosis factor
(TNF)-, interleukin (IL)-6, and IL-1 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- levels (p=0.037),
with no significant changes in the levels of IL-6 and IL-1. All three
proinflammatory cytokines were significantly (p<0.05) higher in
SSRI-refractory than in SSRI-responsive patients. Conclusions: Higher
levels of TNF-, IL-6, and IL-1 might predict nonresponse to fluoxetine
treatment in children.
