Meta-analyses of comparative efficacy of antidepressant medications on peripheral BDNF concentration in patients with depressionReport as inadecuate




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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 0.5395% 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.



Author: Chanjuan Zhou , Jiaju Zhong , Bin Zou , Liang Fang , Jianjun Chen, Xiao Deng, Lin Zhang, Xiang Zhao, Zehui Qu, Yang Lei , Ting Le

Source: http://plos.srce.hr/



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