High baseline BDNF serum levels and early psychopathological improvement are predictive of treatment outcome in major depression

• Published in: Psychopharmacology Vol. 231; no. 15; pp. 2955 - 2965
• Main Authors: Mikoteit, Thorsten, Beck, Johannes, Eckert, Anne, Hemmeter, Ulrich, Brand, Serge, Bischof, Roland, Holsboer-Trachsler, Edith, Delini-Stula, Alexandra
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2014; Springer; Springer Nature B.V
• Subjects: Adult; Antidepressants; Antidepressive Agents - therapeutic use; Biomedical and Life Sciences; Biomedicine; Blood Chemical Analysis; Brain-derived neurotrophic factor; Brain-Derived Neurotrophic Factor - blood; Care and treatment; Depressive Disorder, Major - blood; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Duloxetine Hydrochloride; Female; Health aspects; Humans; Major depressive disorder; Male; Mental depression; Neurosciences; Original Investigation; Patient outcomes; Pharmacology/Toxicology; Prognosis; Prospective Studies; Psychiatric Status Rating Scales; Psychiatry; Psychopathology; Switzerland; Thiophenes - therapeutic use; Time Factors; Treatment Outcome; Response; Treatment outcome; Early response; Brain-derived neurotrophic factor (BDNF); Antidepressants; Serum; Depression; Remission; Duloxetine; Serotonin norepinephrine reuptake inhibitor (SNRI)
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-014-3475-8

Rationale Major depressive disorder has been associated with low serum levels of brain-derived neurotrophic factor (sBDNF), which is functionally involved in neuroplasticity. Although sBDNF levels tend to normalize following psychopathological improvement with antidepressant treatment, it is unclear how closely sBDNF changes are associated with treatment outcome. Objectives To examine whether baseline sBDNF or early changes in sBDNF are predictive of response to therapy. Methods Twenty-five patients with major depressive disorder underwent standardized treatment with duloxetine. Severity of depression, measured by the Hamilton Depression Rating Scale, and sBDNF were assessed at baseline, and after 1, 2, and 6 weeks of treatment. Therapy outcome after 6 weeks was defined as response (≥50 % reduction in baseline Hamilton Depression Rating score) and remission (Hamilton Depression Rating score <8). The predictive values for treatment outcome of baseline sBDNF, and early (i.e., ≤2 weeks) changes in sBDNF and Hamilton Depression Rating score were also assessed. Results At baseline, sBDNF correlated with Hamilton Depression Rating scores. Treatment response was associated with a higher baseline sBDNF concentration, and a greater Hamilton Depression Rating score reduction after 1 and 2 weeks. A greater early rise in sBDNF correlated with a decreased early Hamilton Depression Rating score reduction. Conclusions Even though higher baseline sBDNF levels are associated with more severe depression, they may reflect an increased capacity to respond to treatment. In contrast, changes in sBDNF over the full course of treatment are not associated with psychopathological improvement.