Mysteries Remain in the Relationship Between Inflammation and Depression

April 5, 2017 · Posted in Course of Illness, Theory 

Test tube with blood for CRP test

At the 2017 meeting of the American College of Psychiatrists, researchers Charles L. Raison and Vladimir Maletic gave a plenary lecture on the role of inflammation in depression. Meta-analyses have confirmed that inflammatory markers including Il-1, Il-6, TNF alpha, and CRP are elevated in about 1/3 of depressed patients. However, Raison and Maletic made the point that anti-inflammatory medications are not for everyone. While patients with elevated levels of CRP at baseline responded to an anti–TNF alpha antibody, patients with low CRP values at baseline actually got worse.

Raison and Maletic cited three studies that have also linked CRP to differential response to traditional antidepressants. In unipolar depression, those with low CRP respond well to selective serotonin reuptake inhibitor (SSRI) antidepressants, while those with elevated blood levels of CRP seem to respond better to a dopamine-active antidepressant such as bupropion or a noradrenergic-active antidepressant such as nortriptyline or the serotonin norepinephrine reuptake inhibitor (SNRI) antidepressant duloxetine. Patients with high inflammation at baseline also seem to respond better to intravenous ketamine and oral doses of omega-3 fatty acids.

Studies of animals have suggested that inflammation throughout the body is implicated in depression. Studies in which rodents are repeatedly defeated by larger animals show that these animals have increased inflammation from lymphocites (a type of white blood cells) in the blood, and monocytes (another type of white blood cells) from the bone marrow and spleen. This inflammation can induce depression-like behaviors in the rodents, which is prevented if the inflammatory mechanisms are blocked. These data suggest that depression is not just in the brain—inflammation from all over the body plays an important role.

Psychosocial stressors can also increase inflammation. Inflammation in response to a stressor is more dramatic in patients with a history of adversity in childhood.
One key issue that needs clarification is the sequence in which inflammatory changes occur. Patients who undergo an immune challenge with the inflammatory cytokine interferon-alpha (used to treat hepatitis C) experience depression, and there is a large acute increase in inflammatory markers (such as p38 and MAP kinase) in proportion to the severity of the depression. However, weeks later the elevated markers are no longer evident.

Paradoxically, some immune challenges may even have therapeutic effects in depression. For example, an infusion of lipopolysaccharides (molecules that make up the outer membrane of certain bacteria) actually improves depression. Whole body hyperthermia is another inflammation-causing treatment in which the body’s temperature is increased from 98.7 degrees Fahrenheit to well over 100 degrees using hot water blankets or large incubator-like chambers. This produces increases in inflammatory marker IL-6. Surprisingly, this therapy sometimes used for cancer produces antidepressant effects the following day, which correlate with the degree of increased inflammation.


Comments are closed.

Uterine fibroids natural therapy - cure for uterine fibroids category: people blogs license: standard youtube license 0 likes, 0 dislikes show more show less link to this comment: share to: see all all comments (0) sign in or sign up now to post a comment! loading comment... The role of ufe as an alternative to myomectomy in women desiring future pregnancies remains unclear. does viagra affect young men The university hospital of columbia and cornell. viagra 20 viagra100 An abnormal fetal position, such as breech position , at birth. nbsp lancet 19742:983-985. Treatment treatment depends on various factors, including: age general health severity of symptoms type of fibroids whether you are pregnant if you want children in the future some women may just need pelvic exams or ultrasounds every once in a while to monitor the fibroid's growth. do boots sell viagra over the counter Research has also shown that some factors may protect a woman from developing fibroids. Word of mouth is a large part of it. nbsp lancet 19742:983-985. 02. Anemia can occur if bleeding is severe pain, pressure, or feeling of fullness in the pelvis, abdomen, or lower back frequent urination or constipation pain during or bleeding after intercourse infertility or miscarriage how fibroids are diagnosed? Clinical history and physical exam pelvic ultrasound (us) including hysterosonography magnetic resonance imaging (mri) laparoscopy or hysteroscopy how are fibroids currently treated? Small no symptoms -- follow with us and pelvic exam mild symptoms shy conservative, otc medications, birth control pills moderate symptoms shyaggressive hormonal therapy (lupron) severe symptoms--surgical, most commonly hysterectomy or myomectomy. Mehl-madrona l. Word of mouth is a large part of it.