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
substances.
1Pollmächer
et al. J Clin Psychopharmacol 1996, 16:403-409
2Pollmächer et al. Am J
Psychiatry 1997, 145:1763-1765