Antidepressive Effect of Mirtazapine in Post-Myocardial Infarction Depression Is Associated with Soluble TNF-R1 Increase: Data from the MIND-ITTulner D.M.a · Smith O.R.F.i · Schins A.c · de Jonge P.e · Quere M.b · Delanghe J.R.j · Crijns H.J.d · den Boer J.A.f · Korf J.f · Honig A.g, h
Departments of aPsychiatry and bCardiology, Medical Centre Leeuwarden, Leeuwarden, cDepartment of Psychiatry, University Hospital Maastricht, and dDepartment of Cardiology, University Hospital Maastricht, Maastricht, eInternal Medicine and Psychiatry, and fDepartment of Biological Psychiatry, University Medical Centre Groningen, Groningen, gDepartment of Psychiatry, St. Lucas Andreas Hospital, and hDepartment of Psychiatry, Free University of Amsterdam, Amsterdam, The Netherlands; iDepartment of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway; jDepartment of Clinical Chemistry, Ghent University, Ghent, Belgium
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Article / Publication Details
Background: Depressive disorder after myocardial infarction (MI) is associated with increased cardiac morbidity and mortality. Immune activity such as inflammation might be implicated as an underlying mechanism. The purpose of this study is to investigate whether the response to an antidepressant in post-MI depression is associated with changes of inflammatory markers in serum. Methods: In a double-blind placebo-controlled study with mirtazapine 30 mg/day (50 patients), the antidepressive effect was related to immune activation parameters. The cytokines interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α), the soluble cytokine receptors sIL-6R, sTNF-R1 and sTNF-R2, and the inflammation-sensitive plasma proteins C-reactive protein and neopterin were assessed. Results: Subgroup analyses revealed a highly significant correlation of pronounced sTNF-R1 increase with a decrease in depressive symptoms in antidepressant responders. Conclusion: Significant effects on inflammation accompany the therapeutic efficacy of mirtazapine in contrast to the therapeutic efficacy of placebo and the nontherapeutic efficacy of mirtazapine.
© 2011 S. Karger AG, Basel
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