Effects of fluoxetine and escitalopram on C-reactive protein in patients of depression
Effects of fluoxetine and escitalopram on C-reactive protein in patients of depression
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DOI：
10.4103/0976-500x.77091
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发表时间：
2011-01-01
影响因子：
0.2
通讯作者：
Jayakaran
中科院分区：
文献类型：
--
作者：
Chavda, Nilesh;Kantharia, N. D.;Jayakaran
目的：研究氟西汀和艾司西酞普兰对初诊抑郁症患者的抗炎作用，并探讨抑郁症与炎症的关系。材料与方法：98例初诊抑郁症患者为病例组。其中，48名患者开始氟西汀（20 mg/天）治疗，50名患者开始艾司西酞普兰（20 mg/天）治疗。治疗2个月后测定汉密尔顿抑郁量表（HRSD量表）、C反应蛋白（CRP）、血沉（ESR）、白色细胞（WBC）计数，并与治疗前比较。选取100名健康志愿者作为对照组，测定其CRP、ESR和WBC计数，并与病例组的基线值进行比较。采用HRSD量表评定抑郁程度，采用CRP、ESR和WBC计数降低法测定抗炎活性。结果如下：病例组与对照组基线比较，CRP（P = 0.014）、ESR（P = 0.023）、WBC计数（P = 0.020）明显升高。氟西汀（20 mg/d）治疗组治疗2个月后CRP（P = 0.046）、ESR（P = 0.043）、WBC（P = 0.021）较治疗前明显下降，但HRSD评分无明显下降（P = 0.190）。艾司西酞普兰治疗组治疗2个月后CRP（P = 0.041）、ESR（P = 0.030）和WBC计数（P = 0.017）显著下降，但HRSD评分无显著下降（P = 0.169）。结论：在新诊断的抑郁症患者中，炎症标志物如CRP、ESR和WBC计数显著升高，而选择性5-羟色胺再摄取抑制剂如氟西汀和艾司西酞普兰则独立于其抗抑郁作用而降低炎症标志物。因此，SSRIs具有一定的抗炎活性，独立于其抗抑郁作用。
Objective: To study the anti-inflammatory activity of fluoxetine and escitalopram in newly diagnosed patients of depression and also to evaluate the association between depression and inflammation. Materials and Methods: Ninety-eight newly diagnosed patients of depression were recruited as cases. From these, 48 had started treatment with fluoxetine (20 mg/day) and 50 had started treatment with escitalopram (20 mg/day). After 2 months of treatment of these patients, Hamilton rating scale for depression (HRSD scale), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count were measured and compared to their respective baseline values before starting treatment. One hundred healthy volunteers were recruited as controls and their baseline of CRP, ESR and WBC count were measured and compared with their respective baseline values of cases. Severity of depression was measured by HRSD scale and anti-inflammatory activity was measured by reduction CRP, ESR and WBC count. Results: On baseline comparison between cases and controls, there were significant increases in the levels of CRP (P = 0.014), ESR (P = 0.023) and WBC count (P = 0.020) in cases. In fluoxetine (20 mg/day) treatment group, there was a significant reduction in the levels of CRP (P = 0.046), ESR (P = 0.043) and WBC count (P = 0.021) after 2 months of treatment but no significant reduction in HRSD scale (P = 0.190). Similarly, in escitalopram treatment group, there was a significant reduction in CRP (P = 0.041), ESR (P = 0.030) and WBC count (P = 0.017) after 2 months of treatment but no significant reduction in HRSD scale (P = 0.169). Conclusion: In newly diagnosed patients of depression, inflammatory markers such as CRP, ESR and WBC count were significantly raised and Selective serotonin reuptake inhibitors SSRIs such as fluoxetine and escitalopram reduced them independent of their antidepressant effect. So, SSRIs have some anti-inflammatory activity independent of their antidepressant action.