Effects of bupropion augmentation on pro-inflammatory cytokines in escitalopram-resistant patients with major depressive disorder

J Psychopharmacol. 2009 Sep;23(7):854-8. doi: 10.1177/0269881108091077. Epub 2008 Jun 18.

Abstract

Studies so far have provided contradictory results on immune system markers during use of antidepressants. There are no data on changes in immune parameters after treatment augmentation. The present study aimed to clarify whether the addition of bupropion in escitalopram-resistant patients with major depression causes changes in the immune system and whether treatment response could be predicted by baseline levels of cytokines. We recruited 28 depressive patients (11 men and 17 women) who did not respond to 12-week treatment with escitalopram (20 mg/d) for an augmentation trial with bupropion (150-300 mg/day). The levels of soluble interleukin-2 receptor, interleukin-8 (IL-8) and tumor-necrosis factor-alpha were measured before and 6 weeks after addition of bupropion. For a control group, we recruited 45 healthy volunteers (19 men and 26 women). The results indicated that the baseline levels of studied cytokines did not predict treatment response to bupropion augmentation. Concentration of IL-8 increased during the treatment similarly in both responder and non-responder groups. Although bupropion augmentation had increased the response rate in escitalopram-resistant patients, this clinical improvement was not accompanied by specific changes in studied cytokine levels.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bupropion / administration & dosage*
  • Bupropion / pharmacology*
  • Case-Control Studies
  • Citalopram / therapeutic use*
  • Cytokines / blood*
  • Depressive Disorder, Major / blood*
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / immunology
  • Dopamine Uptake Inhibitors / administration & dosage*
  • Drug Resistance / drug effects*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Selective Serotonin Reuptake Inhibitors / administration & dosage*

Substances

  • Cytokines
  • Dopamine Uptake Inhibitors
  • Serotonin Uptake Inhibitors
  • Bupropion
  • Citalopram