Effect of selective serotonin reuptake inhibitors and immunomodulator on cytokines levels: an alternative therapy for patients with major depressive disorder

Clin Dev Immunol. 2013:2013:267871. doi: 10.1155/2013/267871. Epub 2013 Nov 17.

Abstract

Major depressive disorder (MDD) is a psychiatric illness that presents as a deficit of serotonergic neurotransmission in the central nervous system. MDD patients also experience alterations in cortisol and cytokines levels. Treatment with selective serotonin reuptake inhibitors (SSRIs) is the first-line antidepressant regimen for MDD. The aim of this study was to determine the effect of a combination of SSRIs and an immunomodulator-human dialyzable leukocyte extract (hDLE)-on cortisol and cytokines levels. Patients received SSRIs or SSRIs plus hDLE. The proinflammatory cytokines IL-1 β , IL-2, and IFN- γ ; anti-inflammatory cytokines IL-13 and IL-10; and 24-h urine cortisol were measured at weeks (W) 0, 5, 20, 36, and 52 of treatment. The reduction in cortisol levels in the SSRI-treated group was 30% until W52, in contrast, the combined treatment induced a 54% decrease at W36. The decline in cortisol in patients who were treated with SSRI plus hDLE correlated with reduction of anti-inflammatory cytokines and increases levels of proinflammatory cytokines at the study conclusion. These results suggest that the immune-stimulating activity of hDLE, in combination with SSRIs, restored the pro- and anti-inflammatory cytokine balance and cortisol levels in depressed patients versus those who were given SSRIs alone.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cytokines / blood
  • Cytokines / metabolism*
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / metabolism*
  • Female
  • Humans
  • Hydrocortisone / metabolism
  • Hydrocortisone / urine
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / therapeutic use*
  • Inflammation Mediators / blood
  • Inflammation Mediators / metabolism
  • Male
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Cytokines
  • Immunologic Factors
  • Inflammation Mediators
  • Serotonin Uptake Inhibitors
  • Hydrocortisone