Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Republic of Korea.
Department of Psychiatry, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
Sci Rep. 2021 Dec 20;11(1):24226. doi: 10.1038/s41598-021-03753-3.
Despite the recognized antidepressant role of serotonin (5-hydroxytryptamine [5-HT]) signaling pathways in the central nervous system, the association between baseline peripheral 5-HT level and the antidepressant treatment response in clinical studies remains debatable. We investigated the interaction effects of baseline serum 5-HT level and age on the 12-week remission in outpatients with depressive disorders who received stepwise antidepressant treatment. Baseline serum serotonin levels were measured and the age of 1094 patients recorded. The patients received initial antidepressant monotherapy; then, patients with an insufficient response or who experienced uncomfortable side effects received alternative treatments every 3 weeks (3, 6, and 9 weeks). Subsequently, 12-week remission, defined as a Hamilton Depression Rating Scale (HAMD) score of ≤ 7, was evaluated. Individual and interaction effects of serum 5-HT level (as a binary [low vs. high, based on the median value of 72.6 ng/mL] or continuous variable) and age (as a binary [< 60 vs. ≥ 60 years] or continuous variable) on the 12-week remission rate were analyzed using logistic regression models after adjusting for relevant covariates. High 5-HT (≥ 72.6 ng/mL) and age ≥ 60 years were associated with the highest 12-week remission rates and a significant multiplicative interaction effect. The interaction effect of the two variables on the 12-week remission rate was significant even when analyzed as a continuous variable. Our study suggests that the association between baseline serum 5-HT level and 12-week antidepressant treatment outcomes differs according to patient age.
尽管中枢神经系统中 5-羟色胺（5-HT）信号通路的抗抑郁作用已得到公认，但在临床研究中，基线外周 5-HT 水平与抗抑郁治疗反应之间的相关性仍存在争议。我们研究了基线血清 5-HT 水平和年龄对接受逐步抗抑郁治疗的门诊抑郁障碍患者 12 周缓解的交互作用。测量了基线血清 5-HT 水平，并记录了 1094 名患者的年龄。患者接受初始抗抑郁单药治疗；然后，对反应不足或出现不适副作用的患者，每 3 周（第 3、6 和 9 周）更换替代治疗。随后，评估了 12 周的缓解，定义为汉密尔顿抑郁量表（HAMD）评分≤7。使用逻辑回归模型分析血清 5-HT 水平（作为二分类变量[基于 72.6ng/mL 的中位数，低与高]或连续变量）和年龄（作为二分类变量[<60 岁与≥60 岁]或连续变量）对 12 周缓解率的个体和交互作用，调整了相关协变量。高 5-HT（≥72.6ng/mL）和年龄≥60 岁与最高的 12 周缓解率相关，且存在显著的乘法交互作用。即使作为连续变量进行分析，这两个变量对 12 周缓解率的交互作用也具有统计学意义。我们的研究表明，基线血清 5-HT 水平与 12 周抗抑郁治疗结果之间的相关性因患者年龄而异。
