engleski

The effect of antidepressants on peripheral 5-HT markers in major depression

Serotonergic system plays a role in the ethiology and treatment of major depression. The present study investigated the effects of three antidepressants: sertraline, tianeptine and paroxetine, with opposite effects on serotonergic system, on the peripheral platelet serotonin (5-HT) markers (platelet 5-HT concentration and monoamine oxidase (MAO) activity) in major depressive subjects. The aim of the study was to find out the association between pretreatment platelet 5-HT concentration or MAO activity and treatment response in drug-free major depressives. Responders/nonresponders were determined according to the 50% fall in HAMD after 4 weeks of antidepressant treatment. Platelet 5-HT concentration was significantly decreased in depressed responders and nonresponders treated with sertraline (F=5.13 ; df=3, 26 ; p<0.006) or paroxetine (F=6.72 ; df=3, 20 ; p<0.003). At baseline nonresponders to paroxetine had significantly higher platelet 5-HT concentration than responders. Patients treated with tianeptine showed similar platelet 5-HT values (F=2.23 ; df=3, 48 ; p=0.097). Platelet MAO activity did not differ within groups of patients subdivided according to the response to sertraline (F=1.26 ; df=3, 26 ; p=0.307), paroxetine (F=1.57 ; df=3, 20 ; p=0.227), or tianeptine (F=0.41 ; df=3, 48 ; p=0.75), showing that platelet MAO is not associated with a treatment response to antidepressants. Our results suggest that pretreatment platelet 5-HT concentration but not platelet MAO activity might predict therapeutic outcome to proxetine, but not to sertraline or tianeptine, and that depressed patients with a higher baseline platelet 5-HT concentration have poor therapeutic outcome to paroxetine.

major depression; platelet 5-HT concentration; antidepressants

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