Cytokines plasma levels during antidepressant treatment with sertraline and transcranial direct current stimulation (tDCS): results from a factorial, randomized, controlled trial

Author(s)

Brunoni, Andre R. ^{[1, 2, 3]} ; Machado-Vieira, Rodrigo ^{[4, 5]} ; Zarate, Carlos A. ^[5] ; Valiengo, Leandro ^{[1, 4, 2, 3]} ; Vieira, Erica L. M. ^[6] ; Bensenor, Isabela M. ^{[1, 2]} ; Lotufo, Paulo A. ^{[1, 2]} ; Gattaz, Wagner F. ^[4] ; Teixeira, Antonio L. ^[6]

Affiliation

^[1] Univ Sao Paulo, Univ Hosp, Ctr Clin & Epidemiol Res, BR-05508000 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Univ Hosp, Interdisciplinary Ctr Appl Neuromodulat CINA, BR-05508000 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Serv Interdisciplinary Neuromodulat SIN, Dept & Inst Psychiat, BR-05508000 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Lab Neurosci LIM27, Dept & Inst Psychiat, BR-05508000 Sao Paulo - Brazil

^[5] NIMH, Expt Therapeut & Pathophysiol Branch, Intramural Res Program, NIH, Bethesda, MD 20892 - USA

^[6] Fac Med Minas Gerais, Interdisciplinary Lab Med Invest, Belo Horizonte, MG - Brazil

• Document type: Journal article
• Source: Psychopharmacology; v. 231, n. 7, p. 1315-1323, APR 2014.
• Web of Science Citations: 25

Abstract

The inflammatory hypothesis of depression states that increased levels of pro-inflammatory cytokines triggered by external and internal stressors are correlated to the acute depressive state. This hypothesis also suggests that pharmacotherapy partly acts in depression through anti-inflammatory effects. Transcranial direct current stimulation (tDCS) is a novel, promising, non-invasive somatic treatment for depression, although its antidepressant mechanisms are only partly understood. We explored the effects of tDCS and sertraline over the immune system during an antidepressant treatment trial. In a 6-week, double-blind, placebo-controlled trial, 73 antidepressant-free patients with unipolar depression were randomized to active/sham tDCS and sertraline/placebo (2 x 2 design). Plasma levels of several cytokines (IL-2, IL-4, IL-6, IL-10, IL-17a, IFN-gamma, and TNF-alpha) were determined to investigate the effects of the interventions and of clinical response on them. All cytokines, except TNF-alpha, decreased over time, these effects being similar across the different intervention-groups and in responders vs. non-responders. tDCS and sertraline (separately and combined) acute antidepressant effects might not specifically involve normalization of the immune system. In addition, being one of the first placebo-controlled trials measuring cytokines over an antidepressant treatment course, our study showed that the decrease in cytokine levels during the acute depressive episode could involve a placebo effect, highlighting the need of further placebo-controlled trials and observational studies examining cytokine changes during depression treatment and also after remission of the acute depressive episode. (AU)

• FAPESP's process: 12/20911-5 - Escitalopram and transcranial direct current stimulation in major depressive disorder: a double blind, placebo-controlled, randomized, non-inferiority trial
• Grantee: Andre Russowsky Brunoni
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 09/05728-7 - A factorial, double-blinded, randomized clinical trial on major depressive disorder using transcranial direct current stimulation
• Grantee: Felipe Fregni
• Support Opportunities: Regular Research Grants