engleski

Peripheral biochemical markers as indicators of the clinical response to antidepressant treatment in major depressive disorder

Antidepressant treatment is time-consuming, costly and one third of depressed patients do not respond to treatment. The solution to overcome these problems might be to find out the adequate biochemical marker(s) for the prediction of therapeutic response and for the selection of the best treatment for each patient. Baseline platelet serotonin (5-HT) values, platelet monoamine oxidase activity and serum lipid levels were all reported to possess some predictive value of the outcome in clinical trials. The most interesting finding is that nonresponders to treatment with different serotonergic antidepressants (SSRIs: fluvoxamine, paroxetine, sertraline) have higher pretreatment values of platelet 5-HT than patients with good therapeutic response. It is proposed that a change in cholesterol levels may influence 5-HT uptake in serotonergic neurons and platelets. In this respect several studies pointed out a link between platelet 5-HT content and serum lipid levels. It is interesting that increased cholesterol levels were observed in depressed patients with nonresponse to fluoxetine treatment. During the last few years the search for the adequate biological predictor(s) of the clinical outcome to antidepressants expanded to the investigations of the genotypes of proteins involved in the metabolism, reuptake of 5-HT and 5-HT receptors characteristics, but with inconsistent results.

antidepressant treatment; biological markers; clinical response

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