Journal of Developing Drugs
Open Access
ISSN: 2329-6631
+44 1478 350008
ISSN: 2329-6631
+44 1478 350008
Varsha Ramesh
Sri Ramachandra Institute of Higher Education & Research, India
Posters & Accepted Abstracts: J Dev Drugs
Statement of the Problem: Depression is the fifth leading cause of disability worldwide and is a major contributor to the global burden of diseases. Selective Serotonin Reuptake Inhibitors (SSRIs) are amongst the most commonly prescribed antidepressants. Antidepressant effects are generally not seen until 2- 4 weeks of treatment, when the rates of suicides are also high. Response to treatment with SSRIs varies considerably between patients. The aim of this study was to identify biomarkers which predict response to antidepressants and those that change during antidepressant treatment. Methodology: 50 patients were recruited from Dept. of Psychiatry, Sri Ramachandra Medical College Hospital, a tertiary care hospital, Chennai, India, after IEC approval. Patients with unipolar depression (DSM- V criteria) with a minimum baseline score of 15 on the 21- HAM-D scale, being started on SSRIs, were recruited. After 8 weeks of treatment, responders were defined as those with at least 50% decrease in HAM-D score or a total score of â?¤7. hsCRP (high sensitivity C-reactive protein), BDNF (Brain derived neurotrophic factor) and NRG1β1 (Neuregulin 1 beta 1) were analysed using commercially available ELISA kits. Findings: Mean age was 41.4 years. Response rate was 58%. The HAM-D score decreased after treatment from 20.04 to 10.26 (p value: < .001). The responder and non-responder groups were compared and analysed. There was no significant correlation between baseline NRG1β1 levels and response. Conclusion & Significance: Low levels of serum hsCRP and high levels of BDNF prior to treatment predicted better response to SSRIs in patients with MDD and also changed longitudinally during treatment with SSRIs. Pre-treatment serum levels of NRG1β1 did not predict outcome to treatment but did decrease during treatment with SSRIs. Hence, these can be candidate markers in predicting response prior to starting treatment with SSRIs. Recent Publications: 1. Brydon L, Harrison NA, Walker C, Steptoe A, Critchley HD. Peripheral inflammation is associated with altered substantia nigra activity and psychomotor slowing in humans. Biol Psychiatry. 2008;63:1022â??1029. 2. Wright CE, Strike PC, Brydon L, Steptoe A. Acute inflammation and negative mood: mediation by cytokine activation. Brain Behav Immun. 2005;19:345â??350. 3. Hamer M, Batty GD, Marmot MG, Singh-Manoux A, Kivimäki M. Antidepressant medication use and C-reactive protein: results from two population-based studies. Brain, behavior, and immunity. 2011 Jan 31;25(1):168-73. 4. Hashimoto K (2010) Brain-derived neurotrophic factor as a biomarker for mood disorders: an historical overview and future directions. Psychiatry Clin Neurosci 64(4):341â??357. doi:10.1111/ j.1440-1819.2010.02113.x 5. Fernandes CC, Pinto-Duarte A, Ribeiro JA, Sebastião AM (May 2008). "Postsynaptic action of brain-derived neurotrophic factor attenuates alpha7 nicotinic acetylcholine receptor-mediated responses in hippocampal interneurons". The Journal of Neuroscience. 28 (21): 5611â??8. PMID 18495895. doi:10.1523/JNEUROSCI.5378-07.2008. 6. Huang TL, Lee CT, Liu YL. Serum brain-derived neurotrophic factor levels in patients with major depression: effects of antidepressants. J Psychiatr Res 2008;42:521â??5. 7. Santarelli L, Saxe M, Gross C, Surget A, Battaglia F, et al. (2003) Requirement of hippocampal neurogenesis for the behavioral effects of antidepressants. Science 301: 805â??809. 8. Surget A, Tanti A, Leonardo ED, Laugeray A, Rainer Q, et al. (2011) Antidepressants recruit new neurons to improve stress response regulation. Mol Psychiatry. 9. Chohan TW, Boucher AA, Spencer JR, Kassem MS, Hamdi AA, Karl T et al. Partial genetic deletion of neuregulin 1 modulates the effects of stress on sensorimotor gating, dendritic morphology, and HPA axis activity in adolescent mice. Schizophr Bull 2014; 40: 1272â??1284.
Varsha Ramesh has completed her MD Pharmacology and is currently pursuing her PhD under Indian Council of Medical Research. She is working on detecting novel serum biomarkers and genetic polymorphisms related to outcomes to treatment with Selective Serotonin Reuptake Inhibitors in patients with moderate to severe depression.
E-mail: dr.rameshvarsha@gmail.com