Changes in interleukin‐6 levels during electroconvulsive therapy may reflect the therapeutic response in major depression

• Published in: Acta psychiatrica Scandinavica 2017-01, Vol.135 (1), p.87-92
• Main Authors: Järventausta, K., Sorri, A., Kampman, O., Björkqvist, M., Tuohimaa, K., Hämäläinen, M., Moilanen, E., Leinonen, E., Peltola, J., Lehtimäki, K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; cytokine; Depressive Disorder, Major - therapy; Electroconvulsive therapy; Electroconvulsive Therapy - methods; Female; Glycoproteins; Humans; Interleukin 1 Receptor Antagonist Protein - metabolism; Interleukin-1beta - metabolism; Interleukin-6 - immunology; Interleukin-6 - metabolism; major depressive disorder; Male; Mental depression; Middle Aged; Psychiatry; seizure; Time Factors; Treatment Outcome
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.12665

Objective Interleukin‐6 (IL‐6) has been reported to be elevated in major depressive disorder (MDD) but decreased by antidepressive medication. IL‐6 levels are markedly elevated both after epileptic seizures and single electroconvulsive therapy (ECT) session, but long‐term changes in IL‐6 levels after ECT have not been studied. The correlation between immediate and long‐term changes in proinflammatory cytokines and outcome after ECT was investigated. Method Thirty patients suffering from MDD participated in the study. IL‐6, interleukin‐1β (IL‐1β) and interleukin‐1 receptor antagonist (IL‐1RA) levels were examined at baseline and at 2 and 4 h after the first, fifth and the last ECT sessions. The response to ECT was measured with Montgomery‐Åsberg Depression Rating Scale (MADRS). Results ECT repeatedly caused an increase in IL‐6 levels at the 4‐h time point. However, the baseline IL‐6 levels decreased among remitters, but not among non‐remitters, towards the end of ECT. IL‐1β levels were mostly below detectable level, and IL‐1Ra levels did not change during and after ECT. Conclusion ECT has distinct acute and long‐term effects on IL‐6 levels. Interestingly, the long‐term effect of ECT on IL‐6 seems to correlate with outcome, providing further evidence of the mechanism of action of ECT and supporting the inflammation theory in MDD.