title: Antidepressive effect of mirtazapine in post-myocardial infarction depression is associated with soluble TNF-R1 increase: data from the MIND-IT.
abstract: BACKGROUND
  Depressive disorder after myocardial infarction (MI) is associated with increased cardiac morbidity and mortality. Immune activity such as inflammation might be implicated as an underlying mechanism. The purpose of this study is to investigate whether the response to an antidepressant in post-MI depression is associated with changes of inflammatory markers in serum.
  
  
  METHODS
  In a double-blind placebo-controlled study with mirtazapine 30 mg/day (50 patients), the antidepressive effect was related to immune activation parameters. The cytokines interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α), the soluble cytokine receptors sIL-6R, sTNF-R1 and sTNF-R2, and the inflammation-sensitive plasma proteins C-reactive protein and neopterin were assessed.
  
  
  RESULTS
  Subgroup analyses revealed a highly significant correlation of pronounced sTNF-R1 increase with a decrease in depressive symptoms in antidepressant responders.
  
  
  CONCLUSIONS
  Significant effects on inflammation accompany the therapeutic efficacy of mirtazapine in contrast to the therapeutic efficacy of placebo and the nontherapeutic efficacy of mirtazapine.
authors.affiliation: Department of Psychiatry, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. dmtulner@home.nl
authors.forename: D M
authors.initials: DM
authors.lastname: Tulner
authors.forename: O R F
authors.initials: OR
authors.lastname: Smith
authors.forename: A
authors.initials: A
authors.lastname: Schins
authors.forename: P
authors.initials: P
authors.lastname: de Jonge
authors.forename: M
authors.initials: M
authors.lastname: Quere
authors.forename: J R
authors.initials: JR
authors.lastname: Delanghe
authors.forename: H J
authors.initials: HJ
authors.lastname: Crijns
authors.forename: J A
authors.initials: JA
authors.lastname: den Boer
authors.forename: J
authors.initials: J
authors.lastname: Korf
authors.forename: A
authors.initials: A
authors.lastname: Honig
mesh_terms: D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology / Q000627:therapeutic use*; D003863:Depression / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood / Q000187:drug effects*
chemical_list: D000929:Antidepressive Agents, Tricyclic; D018836:Inflammation Mediators; D047888:Receptors, Tumor Necrosis Factor, Type I; D008803:Mianserin; D000078785:Mirtazapine