Neuroimmune and cortisol changes in selective serotonin reuptake inhibitor and placebo treatment of chronic posttraumatic stress disorder.
BACKGROUND
To explore relations between neuroimmune and neuroendocrine systems relative to posttraumatic stress disorder (PTSD) treatment, cortisol and cytokine changes in response to selective serotonin reuptake inhibitor (SSRI) and placebo treatment of chronic PTSD were assessed prospectively.


METHODS
Baseline measures of PTSD, depression, salivary 8 am and 4 pm cortisol, and serum interleukin-1beta (IL-1beta; pro-inflammatory) and soluble interleukin-2 receptors (IL-2R; cell-mediated immunity) were obtained for 58 PTSD and 21 control subjects. The PTSD subjects participated in a 10-week, double-blind treatment with citalopram (n = 19), sertraline (n = 18), or placebo (n = 7).


RESULTS
At baseline, PTSD subjects had significantly greater PTSD, depression, and IL-1beta and lower IL-2R levels than control subjects, with no group differences found for am or pm cortisol levels. Both SSRI groups' IL-1beta correlated negatively with IL-2R; neither cytokine correlated with cortisol levels. Treatment significantly lowered PTSD, depression, and IL-1beta levels and increased IL-2R for all groups to control subject levels. After treatment, both SSRI groups' IL-1beta correlated with an end cortisol measure (one negatively, one positively).


CONCLUSIONS
Our results support a complex relationship between neuroimmune and neuroendocrine systems with PTSD treatment. Implications of normalization of cytokine levels with effective SSRI treatment and placebo are discussed.
Tucker
Phebe
P
Department of Psychiatry, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73190, USA.
Ruwe
William D
WD
Masters
Barbara
B
Parker
Don E
DE
Hossain
Akm
A
Trautman
Richard P
RP
Wyatt
Dorothy B
DB
D000328:Adult; D002908:Chronic Disease; D002940:Circadian Rhythm; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007375:Interleukin-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015213:Neuroimmunomodulation / Q000187:drug effects; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012016:Reference Values; D012463:Saliva / Q000737:chemistry; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D020280:Sertraline / Q000494:pharmacology / Q000627:therapeutic use; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000188:drug therapy*
D015283:Citalopram; D006854:Hydrocortisone; D007375:Interleukin-1; D015375:Receptors, Interleukin-2; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline