Stanley Lab: Plasma Levels of Cytokines and Soluble Cytokine Receptors In the Course of Treatment With Antidepressants




D. Hinze-Selch*, A.

Schuld, T. Kraus, M. Haack, T. Pollmächer

Max-Planck-Institute of Psychiatry, Munich, Germany

It has been shown that the atypical

neuroleptic compound clozapine1 significantly

increases the plasma levels of the cytokines and soluble cytokine

receptors TNFa , sTNFRp55, sTNFRp75 and sIL-2r whereas the

classic neuroleptic substance haloperidol2 does not.

As immunological alterations have also been described in

depressive patients without data on immunomodulation by

antidepressant drugs we investigated the effect of the tricyclic

antidepressants amitriptylin and nortriptylin and the effect of

the serotonin reuptake inhibitor paroxetin on the plasma levels

of TNFa ,

sTNFRp55, sTNFRp75, sIL-2r and on leukocyte, monoctye, lymphocyte

and granulocyte counts before initiation of treatment with either

one of the tricyclic antidepressants (12 patients) or with

paroxetin (10 patients) and at the end of weeks 1, 2 and 5 in 22

inpatients meeting DSM-IV criteria of major depression or

dysthymic disorder. We also monitored the above mentioned

parameters in 10 inpatients meeting various diagnoses who were

kept drug-free during 5 weeks. Statistical analysis was done by

MANOVA and post-hoc tests with contrast, the level of

significance was set to p<0.05.

Treatment with either one of the tricyclic

antidepressants significantly increased sTNFRp55 plasma levels

(1.73 ±

0.43ng/ml; 1.76 ± 0.49ng/ml; 1.86 ± 0.46ng/ml; 1.93 ± 0.57ng/ml; F 3,4; p =0.03) and sTNFRp75 plasma

levels (4.69 ± 1.35ng/ml; 5.03 ± 1.21ng/ml; 5.05 ± 0.94ng/ml; 5.47 ± 1.33ng/ml; F 5.9; p = 0.002) from baseline to week

1, 2 and 5 of treatment. Plasma levels of TNFa and sIL-2r and blood

cell counts were not affected. Treatment with paroxetin had no

significant effect on any of the parameters assessed as well as

in drug-free patients no variation across time was found.

We conclude that, similar to neuroleptic

agents, some antidepressants have immunomodulatory effects

whereas others have not. Therefore, investigations on

immunological variables in psychiatric disorders should carefully

control for possible confounding effects of psychotropic



et al. J Clin Psychopharmacol 1996, 16:403-409

2Pollmächer et al. Am J

Psychiatry 1997, 145:1763-1765