Selective serotonin reuptake inhibitors influence levels of inflammatory markers

  • Wang L & al.
  • Brain Behav Immun
  • 21 Feb 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis indicates moderate immunomodulating effects of selective serotonin reuptake inhibitors (SSRI) treatment for major depressive disorder (MDD).
  • SSRI treatment reduced levels of pro-inflammatory interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and IL-1β, and anti-inflammatory IL-10.

Why this matters

  • Several studies have shown that antidepressants, particularly SSRIs, reduce inflammatory marker levels in patients with MDD, however, results are inconsistent.

Study design

  • 22 studies involving 827 patients with MDD met eligibility criteria after a search across Pubmed, Web of Science, Embase and Cochrane databases.
  • Funding: Funded by an award from the State Administration of Foreign Experts Affairs, China.

Key results

  • The pooled results showed that SSRIs significantly reduced pro-inflammatory markers levels such as:
    • IL-6 (Hedges’g, −0.418; P=.001; I2, 89.412),
    • TNF-α (Hedges’ g, −0.554; P=.013; I2, 95.438) and
    • IL-1β (Hedges’ g, −0.574; P=.010; I2, 91.622).
  • SSRIs showed significant reduction in anti-inflammatory marker, IL-10 (Hedges’ g, −0.615; P=.001; I2, 90.406).
  • SSRIs did not show any significant effect on IL-2 (Hedges’g, −0.618; P=.264; I2, 97.189), IL-4 (Hedges’g, 0.118; P=.786; I2, 96.204) and interferon-γ (Hedges’g, −0.440; P=.533; I2, 97.193) levels.

Limitations

  • Heterogeneity among included studies
  • Small sample sizes in included studies.

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