Abstract: The interplay between immune and nervous systems plays a pivotal role in the pathophysiology of depression. In depressive episodes, patients show increased production of pro-inflammatory cytokines such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α. There is limited information on the effect of antidepressant drugs on cytokines, most studies report on a limited sample of cytokines and none have reported effects on IL-22. We systematically investigated the effect of three antidepressant drugs, citalopram, escitalopram and mirtazapine, on secretion of cytokines IL-1β, IL-2, IL-4, IL-6, IL-17, IL-22 and TNF-α in a whole blood assay in vitro, using murine anti-human CD3 monoclonal antibody OKT3, and 5C3 monoclonal antibody against CD40, to stimulate T and B cells respectively. Citalopram increased production of IL-1β, IL-6, TNF-α and IL-22. Mirtazapine increased IL-1β, TNF-α and IL-22. Escitalopram decreased IL-17 levels. The influence of antidepressants on IL-2 and IL-4 levels was not significant for all three drugs. Compared to escitalopram, citalopram led to higher levels of IL-1β, IL-6, IL-17 and IL-22; and mirtazapine to higher levels of IL-1β, IL-17, IL-22 and TNF-α. Mirtazapine and citalopram increased IL-22 production. The differing profile of cytokine production may relate to differences in therapeutic effects, risk of relapse and side effects.
Keywords: cytokines; depression; antidepressants; citalopram; escitalopram; mirtazapine
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Munzer, A.; Sack, U.; Mergl, R.; Schönherr, J.; Petersein, C.; Bartsch, S.; Kirkby, K.C.; Bauer, K.; Himmerich, H. Impact of Antidepressants on Cytokine Production of Depressed Patients in Vitro. Toxins 2013, 5, 2227-2240.
Munzer A, Sack U, Mergl R, Schönherr J, Petersein C, Bartsch S, Kirkby KC, Bauer K, Himmerich H. Impact of Antidepressants on Cytokine Production of Depressed Patients in Vitro. Toxins. 2013; 5(11):2227-2240.
Munzer, Alexander; Sack, Ulrich; Mergl, Roland; Schönherr, Jeremias; Petersein, Charlotte; Bartsch, Stefanie; Kirkby, Kenneth C.; Bauer, Katrin; Himmerich, Hubertus. 2013. "Impact of Antidepressants on Cytokine Production of Depressed Patients in Vitro." Toxins 5, no. 11: 2227-2240.