Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Department of Hospital Pharmacy, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Neuropsychobiology. 2017;75(3):145-150. doi: 10.1159/000484665. Epub 2018 Jan 12.
BACKGROUND/AIMS: Serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) were prospectively monitored in relation with therapeutic response to lamotrigine augmentation therapy in 46 (15 males and 31 females) inpatients with treatment-resistant depressive disorder during an 8-week treatment with lamotrigine using an open-study design.
The subjects were 46 depressed patients who had already shown insufficient response to at least 3 psychotropics including antidepressants, mood stabilizers, and atypical antipsychotics. The diagnoses were major depressive disorder (n = 19), bipolar I disorder (n = 6), and bipolar II disorder (n = 22). The final doses of lamotrigine were 100 mg/day for 26 subjects who were not taking valproate and 75 mg/day for 20 subjects taking valproate, respectively. Depressive symptoms were evaluated by the Montgomery-Åsberg Depression Rating Scale (MADRS) before and after the 8-week treatment. Blood sampling was performed before the start of lamotrigine treatment and at week 8. Serum BDNF and IL-6 levels were measured using quantitative sandwich enzyme immunoassays.
No significant changes in serum BDNF or IL-6 levels during the 8-week lamotrigine treatment were observed in the total of subjects, responders or nonresponders. There was no significant correlation between the changes in serum BDNF or IL-6 levels and the percent improvement in MADRS scores in the overall subjects.
The present study suggests that the acute effect of lamotrigine augmentation therapy for a major depressive episode is not related to either BDNF or IL-6, at least in patients with treatment-resistant depressive disorder.
背景/目的:采用开放研究设计,前瞻性监测 46 例(男 15 例,女 31 例)治疗抵抗性抑郁症住院患者在接受拉莫三嗪加用治疗的 8 周期间,血清脑源性神经营养因子(BDNF)和白细胞介素-6(IL-6)水平与治疗反应的关系。
该研究对象为 46 例抑郁患者,他们在接受至少 3 种精神药物治疗(包括抗抑郁药、心境稳定剂和非典型抗精神病药)后反应不足。诊断为:重型抑郁症(n=19)、单相 I 型障碍(n=6)和双相 II 型障碍(n=22)。拉莫三嗪的最终剂量为:未服用丙戊酸的 26 例患者每日 100mg,服用丙戊酸的 20 例患者每日 75mg。在 8 周治疗前后,采用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评估抑郁症状。在开始拉莫三嗪治疗前和第 8 周进行采血。采用定量夹心酶联免疫吸附试验测量血清 BDNF 和 IL-6 水平。
在总人群、应答者或无应答者中,均未观察到 8 周拉莫三嗪治疗期间血清 BDNF 或 IL-6 水平的显著变化。在所有受试者中,血清 BDNF 或 IL-6 水平的变化与 MADRS 评分的改善百分比之间无显著相关性。
本研究提示,拉莫三嗪加用治疗首发重性抑郁发作的急性效应与 BDNF 或 IL-6 无关,至少在治疗抵抗性抑郁症患者中是这样。