engleski

Platelet 5-HT markers in depressed patients treated with tianeptine and sertraline

Serotonin (5-HT) is believed to be involved in the pathophysiology and treatment of depressive disorders. The aim of the present study was to compare the effect of two antidepressant drugs with opposite effect on 5-HT uptake: a) sertraline (selective 5-HT reuptake inhibitor and b) tianeptine (a new antidepressant drug, that stimulates 5-HT uptake) on 5-HT system in depressed patients using blood platelets as a peripheral marker for central serotonergic synaptosomes. The study included 33 nonpsychotic, nonsuicidal female depressed patients (DSM-IV criteria) who finished 6 weeks treatment with two antidepressant drugs. In an open study 19 patients were treated with tianeptine (37, 5 mg/daily) and 14 with sertraline (25-100 mg/daily). Platelet 5-HT markers [platelet 5-HT concentration and platelet monoamine oxidase (MAO) activity] were determined before (baseline, i.e. after 8 days of wash-out) and after 6 weeks of treatment with tianeptine or sertraline.There was no significant differences in platelet 5-HT concentration or in platelet MAO activity between two groups before treatment. Significant differences (one-way ANOVA: F3, 62=20.39, p<0.001) in platelet 5-HT concentration were found between groups of patients after 6 weeks of treatment. When compared to corresponding baseline concentrations, an oppossite effect of two antidepressant drugs on platelet 5-HT concentrations was observed: prolonged administration of tiapentine increased (p<0.05, Newman Keuls test), whereas prolonged treatment with sertraline decreased (p<0.05, Newman Keuls test) platelet 5-HT concentrations in depressed patients. Consequently, significant (p<0.05, Newman Keuls test) differences in platelet 5-HT concentration were found between two groups of patients after 6 weeks of antidepressant treatment. Prolonged tiapentine or sertraline treatment did not affect (one-way ANOVA: F3, 62=2.51, p=0.067, NS) platelet MAO activity in depressed patients. Clinical improvement (based on the 50% reduction in HAMD and MADRS scores) was observed in 11 out of 19 (58%) and 10 out of 14 (71%) patients treated with tianeptine and sertraline, respectively. The results of the present study show that sertraline and tianeptine, although possess inverse effect on 5-HT uptake (reflected in opposite changes in platelet 5-HT concentration during prolonged treatment), induce similar clinical effect in depressed patients. Our results suggest also a complex alteration of 5-HT system in the depressive disorders.

serotonin; MAO; blood platelets; tianeptine; sertraline; depression

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