title: Meta-analyses of comparative efficacy of antidepressant medications on peripheral BDNF concentration in patients with depression.
abstract: BACKGROUND
  Brain derived neurotrophic factor (BDNF) is one of the most important regulatory proteins in the pathophysiology of major depressive disorder (MDD). Increasing numbers of studies have reported the relationship between serum/plasma BDNF and antidepressants (ADs). However, the potential effects of several classes of antidepressants on BDNF concentrations are not well known. Hence, our meta-analyses aims to review the effects of differential antidepressant drugs on peripheral BDNF levels in MDD and make some recommendations for future research.
  
  
  METHODS
  Electronic databases including PubMed, EMBASE, the Cochrane Library, Web of Science, and PsycINFO were searched from 1980 to June 2016. The change in BDNF levels were compared between baseline and post-antidepressants treatment by use of the standardized mean difference (SMD) with 95% confidence intervals (CIs). All statistical tests were two-sided.
  
  
  RESULTS
  We identified 20 eligible trials of antidepressants treatments for BDNF in MDD. The overall effect size for all drug classes showed that BDNF levels were elevated following a course of antidepressants use. For between-study heterogeneity by stratification analyses, we detect that length of treatment and blood samples are significant effect modifiers for BDNF levels during antidepressants treatment. While both SSRIs and SNRIs could increase the BDNF levels after a period of antidepressant medication treatment, sertraline was superior to other three drugs (venlafaxine, paroxetine or escitalopram) in the early increase of BDNF concentrations with SMD 0.53(95% CI = 0.13-0.93; P = 0.009).
  
  
  CONCLUSIONS
  There is some evidence that treatment of antidepressants appears to be effective in the increase of peripheral BDNF levels. More robust evidence indicates that different types of antidepressants appear to induce differential effects on the BDNF levels. Since sertraline makes a particular effect on BDNF concentration within a short amount of time, there is potential value in exploring its relationship with BDNF and its pharmacological mechanism concerning peripheral blood BDNF. Further confirmatory trials are required for both observations.
authors.affiliation: Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Chanjuan
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Jiaju
authors.initials: J
authors.lastname: Zhong
authors.affiliation: College of Computer and Information Science, Southwest University, Chongqing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zou
authors.affiliation: Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Fang
authors.affiliation: Institute of Life Sciences, Chongqing Medical University, Chongqing, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Deng
authors.affiliation: College of Computer and Information Science, Southwest University, Chongqing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: College of Computer and Information Science, Southwest University, Chongqing, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhao
authors.affiliation: College of Computer and Information Science, Southwest University, Chongqing, China.
authors.forename: Zehui
authors.initials: Z
authors.lastname: Qu
authors.affiliation: Department of neurology, University-town hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Lei
authors.affiliation: Department of Physics, University of Fribourg, Fribourg, Switzerland.
authors.forename: Ting
authors.initials: T
authors.lastname: Lei
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D015283:Citalopram / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003627:Data Interpretation, Statistical; D003863:Depression / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D017374:Paroxetine / Q000627:therapeutic use; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020280:Sertraline / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D019208:Brain-Derived Neurotrophic Factor; D015283:Citalopram; D017374:Paroxetine; C579455:BDNF protein, human; D000069470:Venlafaxine Hydrochloride; D020280:Sertraline