Citation

Amitai M, Taler M, Ben-Baruch R, Lebow M, Rotkopf R, Apter A, Fennig S, Weizman A, Chen A. Brain Behav. Immun. 2019; ePub(ePub): ePub.

Affiliation

The Ruhman Family Laboratory for Research on the Neurobiology of Stress, Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.bbi.2019.12.017

PMID

31887416

Abstract

OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat anxiety and/or depression in pediatric populations. However, the response rates are low (approximately 50%). Moreover, SSRI use is frequently associated with adverse events (AE). Currently there are no available biomarkers for treatment response/AE. Identification of biomarkers predicting early response and/or AE could help maximize the benefit-risk ratio for the use of SSRIs, and accelerate matching of treatments to patients. Pro-inflammatory cytokines were proposed as potential biomarkers.

METHOD: Ninety-two patients (35 boys and 57 girls) with major depressive disorder or anxiety disorders, aged 13.90 ± 2.41 years, were treated with fluoxetine (FLX) for 8 weeks. Plasma concentrations of TNFα, IL-6, and IL-1β were measured by enzyme linked immunosorbent assays before and after FLX treatment. Clinical response and AE were measured using several clinical scales, including the Clinical Global Impression - improvement, Children's Depression Rating Scale-Revised, the Beck Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, the Columbia suicide severity rating scale, and the Suicide Ideation Questionnaire.

RESULTS: IL-6 levels increased after treatment only in the group of children who developed FLX-associated suicidality.

CONCLUSION: An increase in IL-6 levels during treatment may be a risk factor for the emergence of FLX-associated suicidality (OR=1.70). Further studies are necessary to clarify the role and mechanism(s) of this cytokine in the pathogenesis of this life-threatening AE.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

IL-6; SSRI; adolescents; children; suicidality