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Raised Plasma Levels of Tumor Necrosis Factor α in Patients With Depression: Normalization During Electroconvulsive Therapy

Hestad, Knut A. PhD*†; Tønseth, Sverre MD; Støen, Charlotte D. BS; Ueland, Thor BS‡§; Aukrust, Pål MD, PhD§¶

Original Article

Objective To examine whether electroconvulsive therapy (ECT) could modulate tumor necrosis factor (TNF)α levels in patients with depressive disorders.

Method Plasma levels of TNFα were analyzed in 23 depressed patients, mainly with severe depressive disorders, and in 15 sex- and age-matched healthy controls. Fifteen depressed patients were followed longitudinally with measurement of TNFα before, during, and after repeated ECT treatment. For comparison, TNFα levels were also analyzed longitudinally in the 8 depressed patients not receiving ECT.

Results Patients with depressive disorders had markedly raised TNFα levels compared with healthy controls. The clinical improvement during repeated ECT was accompanied by a gradual and significant decline in TNFα level, reaching levels comparable with those in healthy controls at the end of the study. Such a decline was not seen in the depressed patients not receiving ECT, who instead showed raised TNFα levels throughout the study period.

Conclusion Our findings support an association between inflammation and TNFα in particular and severe depression, and suggest that ECT may down-regulate this immune activation.

*NTNU – Norwegian University of Science and Technology, Department of Psychology, N-7440 Trondheim; †Innlandet Hospital Sanderud, N-2312 Ottestad; and ‡Research Institute for Internal Medicine, §Section of Endocrinology, and ¶Section of Clinical Immunology and Infectious Diseases, Medical Department, Rikshospitalet, University of Oslo, N-0027 Oslo, Norway

Received March 8, 2003; accepted September 4, 2003

Reprints: Knut A. Hestad, PhD, Innlandet Hospital Sanderud, 2312 Ottestad, Norway (e-mail: khestad@online.no).

© 2003 Lippincott Williams & Wilkins, Inc.