title: Antidepressants differentially related to 1,25-(OH)₂ vitamin D₃ and 25-(OH) vitamin D₃ in late-life depression.
abstract: A low plasma 25-OH vitamin D3 level is a universal risk factor for a wide range of diseases and has also been implicated in late-life depression. It is currently unknown whether the biologically active form of vitamin D, that is, 1,25-(OH)2 vitamin D3, is also decreased in late-life depression, or whether vitamin D levels correlate with specific depression characteristics. We determined plasma 25-OH vitamin D3, 1,25-(OH)2 vitamin D3 and parathormone levels in 355 depressed older persons and 124 non-depressed comparison subjects (age 60 years). Psychopathology was established with the Composite International Diagnostic Interview 2.1, together with potential confounders and depression characteristics (severity, symptom profile, age of onset, recurrence, chronicity and antidepressant drug use). Adjusted for confounders, depressed patients had significantly lower levels of 25-OH vitamin D33 (Cohen's d =0.28 (95% confidence interval: 0.07-0.49), P=0.033) as well as 1,25-(OH)2 vitamin D3 (Cohen's d =0.48 (95% confidence interval: 0.27-0.70), P<0.001) than comparison subjects. Of all depression characteristics tested, only the use of tricyclic antidepressants (TCAs) was significantly correlated with lower 1,25-(OH)2 vitamin D3 levels (Cohen's d =0.86 (95% confidence interval: 0.53-1.19), P<0.001), but not its often measured precursor 25-OH vitamin D3. As vitamin D levels were significantly lower after adjustment for confounders, vitamin D might have an aetiological role in late-life depression. Differences between depressed and non-depressed subjects were largest for the biologically active form of vitamin D. The differential impact of TCAs on 25-OH vitamin D3 and 1,25-(OH)2 vitamin D3 levels suggests modulation of 1-α-hydroxylase and/or 24-hydroxylase, which may in turn have clinical implications for biological ageing mechanisms in late-life depression.
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands.
authors.forename: R C
authors.initials: RC
authors.lastname: Oude Voshaar
authors.affiliation: Pro Persona, Department of Old Age Psychiatry, Wolfheze/Arnhem, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: Derks
authors.affiliation: VU Medical Center, Department of Psychiatry and GGZinGeest, EMGO Institute of Health and Care Research, Amsterdam, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Comijs
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Schoevers
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, Groningen, The Netherlands.
authors.forename: M H
authors.initials: MH
authors.lastname: de Borst
authors.affiliation: 1] University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands [2] Pro Persona, Department of Old Age Psychiatry, Wolfheze/Arnhem, The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Marijnissen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000097:blood* / Q000172:deficiency; D003866:Depressive Disorder / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D002762:Cholecalciferol
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