Table 1b.
Predominantly noradrenergic, predominantly dopaminergic, and glutamatergic action: higher response rates in moderate–high inflammatory state vs. low inflammatory state (prior to treatment).
| INFLAMMATORY STATE | STUDY | DRUG | INFLAMMATORY TEST | RESPONSE |
|---|---|---|---|---|
| LOW | Jha et al., 2017 (40) | Escitalopram (SSRI) + Bupropion (NDRI) | CRP < 1 mg/L | Lower response rate compared to m–h IS * |
| MODERATE–HIGH | Jha et al.,2 017 (40) | Escitalopram (SSRI) + Bupropion (NDRI) | CRP ≥ 1 mg/L | Higher response rates compared to low IS * |
| Uher et al., 2014a (41) | Nortriptyline (TCA) | CRP ≥ 1 mg/L | Higher response rates compared to low IS *** | |
| Harley et al., 2010 (49) | Fluoxetine (SSRI) + Nortriptyline (TCA) | CRP ≥ 1 mg/L | Higher response rates compared to low IS *** | |
| Yang et al., 2015 (50) | Ketamine (NMDA Receptor Antagonist) | IL-6 | Higher response rates compared to low IS *** | |
| Gupta et al., 2016 (51) | Mirtazapine (NaSSA) | TNFα | Higher response rates compared to low IS * |
SSRI, selective serotonin reuptake inhibitors; NDRI, norepinephrine dopamine reuptake inhibitor; TCA, tricyclic antidepressant; NaSSA, noradrenergic and specific serotonergic antidepressant; TNFα, tumor necrosis factor alpha; IL, interleukin; CRP, C-reactive protein; m–h, moderate–high; IS, inflammatory state.
*p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001.
a
Improvement on Montgomery–Asberg Depression Rating Scale (MADRS) score 3 points higher with nortriptyline when CRP ≥ 1 mg/L and 3 points higher with escitalopram when CRP < 1 mg/L.