title: The effects of paroxetine and tianeptine on peripheral biochemical markers in major depression.
abstract: Depression is related to the alterations of the central serotonergic system and some antidepressants achieve their therapeutic effects through alteration of serotonin (5-HT) (re)uptake. Peripheral biochemical markers, platelet and serum 5-HT concentrations, platelet monoamine oxidase (MAO) activity, plasma levels of cortisol and prolactin (PRL), were investigated in patients with major depression before and after 4 weeks of treatment with paroxetine (an inhibitor of 5-HT uptake) or tianeptine (a stimulator of 5-HT uptake). Study was open, single center and included female depressed patients, 21 treated with tianeptine (37.5 mg/day) and 15 treated with paroxetine (20 mg/day), and 11 drug-free healthy women (controls). Before treatment, depressed patients as a group had significantly higher serum 5-HT and cortisol concentrations than healthy controls. There were no differences in the other biochemical markers. Response to antidepressant treatment was estimated according to the 50% fall in the initial scores of Hamilton Depression Rating Scale (HAMD) after 4 weeks of treatment. Good therapeutic response was observed in 47% and 45% patients treated with paroxetine and tianeptine, respectively. Paroxetine treatment induced significant decrease in platelet 5-HT concentrations in both responders and nonresponders, while no alterations in platelet 5-HT values were found in tianeptine-treated patients. There was a subgroup of depressed patients in paroxetine-treated group with high pretreatment platelet 5-HT concentration and later poor therapeutic response to paroxetine treatment. Serum 5-HT values, platelet MAO activity or plasma cortisol or PRL levels were unchanged after both treatments. The results suggest that pretreatment platelet 5-HT levels, but not other peripheral biochemical markers, might predict therapeutic outcome at least in paroxetine-treated patients.
authors.affiliation: Ruder Bosković Institute, Division of Molecular Medicine, PO Box 180, HR-10002 Zagreb, Croatia. seler@rudjer.irb.hr
authors.forename: Dorotea
authors.initials: D
authors.lastname: Mück-Seler
authors.forename: Nela
authors.initials: N
authors.lastname: Pivac
authors.forename: Marina
authors.initials: M
authors.lastname: Sagud
authors.forename: Miro
authors.initials: M
authors.lastname: Jakovljević
authors.forename: Alma
authors.initials: A
authors.lastname: Mihaljević-Peles
mesh_terms: D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology*; D015415:Biomarkers / Q000032:analysis*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D008995:Monoamine Oxidase / Q000097:blood / Q000494:pharmacology; D017374:Paroxetine / Q000494:pharmacology*; D011237:Predictive Value of Tests; D011388:Prolactin / Q000097:blood; D012701:Serotonin / Q000097:blood; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D012720:Severity of Illness Index; D013841:Thiazepines / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D015415:Biomarkers; D006854:Hydrocortisone; D008995:Monoamine Oxidase; D017374:Paroxetine; D011388:Prolactin; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D013841:Thiazepines; C050504:tianeptine