title: Combining ECT with pharmacological treatment of depressed inpatients in a naturalistic study is not associated with serum BDNF level increase.
abstract: BACKGROUND
  BDNF blood levels are reduced in MDD. They can be increased with pharmacologic treatment and ECT, but it is not clear whether the combination of treatments promotes an additional increase. The present study aims to evaluate whether combined treatment promotes an increase in BDNF, restoring the level to that of non-depressed controls.
  
  
  METHODS
  Ninety-nine adult inpatients were invited to participate in this naturalistic prospective cohort study between May 2011 and April 2013. Diagnosis was made by MINI, and the symptoms were evaluated at admission and at discharge by HDRS-17. Those inpatients with a diagnosis of depression were included and divided into two groups: those who underwent combined ECT and medication (31 subjects) and those who used only pharmacotherapy (68 subjects). Serum BDNF was measured in blood samples collected at admission and discharge. One hundred healthy blood donors without any psychiatric diagnosis were included as a control group.
  
  
  RESULTS
  There were no significant differences in serum BDNF levels between the combined and pharmacological groups at admission and at discharge, and no significant variation in BDNF occurred in any group during the treatment. There were no interactions between time and treatment groups nor significant time effects or treatment group effects for BDNF in the Generalized Estimating Equation Model (GEE). The control group had significantly higher serum BDNF levels in comparison with each of the treatment groups at admission and discharge (p = 0.00).
  
  
  CONCLUSIONS
  Combination of ECT with pharmacological treatment did not result in increased serum BDNF levels and did not restore levels to that of controls.
authors.affiliation: Programa de Pós-Graduacão em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: thiagofernandovf@yahoo.com.br.
authors.forename: Thiago Fernando Vasconcelos
authors.initials: TF
authors.lastname: Freire
authors.affiliation: Programa de Pós-Graduacão em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Departamento de Psiquiatria e Medicina Legal, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Neusa Sica da
authors.initials: NS
authors.lastname: Rocha
authors.affiliation: Programa de Pós-Graduacão em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Departamento de Psiquiatria e Medicina Legal, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Marcelo Pio de Almeida
authors.initials: MP
authors.lastname: Fleck
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D015331:Cohort Studies; D003863:Depression / Q000097:blood* / Q000628:therapy*; D004562:Electrocardiography; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric
chemical_list: D000928:Antidepressive Agents; D019208:Brain-Derived Neurotrophic Factor
keywords: BDNF; Depression; ECT; Pharmacotherapy