Serum brain-derived neurotrophic factor predicts responses to escitalopram in chronic posttraumatic stress disorder.
BACKGROUND
Some studies have found that antidepressants increase serum brain-derived neurotrophic factor (BDNF) levels in patients with major depression and the expression of BDNF mRNA in limbic structures of rats.


OBJECTIVE
This study addressed whether the SSRI escitalopram increases serum BDNF levels in subjects with PTSD and whether BDNF levels are associated with treatment response.


METHODS
Medically healthy male subjects (N=16) with chronic PTSD completed a 12 week open-label trial of flexible dose (5-20 mg/day) escitalopram monotherapy. BDNF levels were obtained at baseline, and at weeks 4, 8 and 12.


RESULTS
PTSD symptoms significantly declined over the course of the 12 week escitalopram treatment. Despite a substantial improvement in PTSD symptoms, there was virtually no change in BDNF levels over time. Nevertheless, mean BDNF levels across the trial were strongly correlated with the slope of PTSD symptoms over the 12 weeks (r=0.58, p=0.018). Lower mean BDNF was associated with a greater decrease in PTSD symptoms over the course of the trial.


CONCLUSIONS
PTSD subjects with low BDNF levels demonstrated the largest treatment response from an agent with putative neurotrophic effects.
Berger
William
W
Department of Psychiatry, University of California, San Francisco, CA, USA.
Mehra
Akhil
A
Lenoci
Maryann
M
Metzler
Thomas J
TJ
Otte
Christian
C
Tarasovsky
Gary
G
Mellon
Synthia H
SH
Wolkowitz
Owen M
OM
Marmar
Charles R
CR
Neylan
Thomas C
TC
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D002908:Chronic Disease; D015283:Citalopram / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D018687:Antidepressive Agents, Second-Generation; D019208:Brain-Derived Neurotrophic Factor; C019277:brain-derived growth factor; D015283:Citalopram