The specific associations between antidepressant treatment and alterations in the levels of cytokines remain to be elucidated. In this study, we aimed to explore the role of IL-2, IL-4, IL-12, TNF-α, TGF-β1, and MCP-1 in major depression and to investigate the effects of sertraline therapy. Cytokine and chemokine levels were measured at the time of admission and 8 weeks after sertraline treatment. Our results suggest that the proinflammatory cytokines (IL-2, IL-12, and TNF-α) and MCP-1 were significantly higher, whereas anti-inflammatory cytokines IL-4 and TGF-β1 were significantly lower in patients with major depression than those of healthy controls. It seems likely that the sertraline therapy might have exerted immunomodulatory effects through a decrease in the proinflammatory cytokine IL-12 and an increase in the anti-inflammatory cytokines IL-4 and TGF-β1. In conclusion, our results indicate that Th1-, Th2-, and Th3-type cytokines are altered in the depressed patients and some of them might have been corrected by sertraline treatment.

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Mirtazapine augmentation is a good choice for the treatment of SSRI-induced sexual dysfunction, and the results are typically seen later after 4-8 weeks.

There has been no follow-up study regarding the effect of alexithymic features on antidepressant treatment. This study was planned to observe whether alexithymia effects short-term treatment outcome in depression. The study included 32 alexithymic and 33 nonalexithymic outpatients with major depression. Depression was assessed on the basis of the Structured Clinical Interview for DSM-IV (SCID-I). Level of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAM-D). Alexithymia was screened using the Turkish version of Toronto Alexithymia Scale (TAS-20). All patients received 20 mg/d paroxetine for 10 weeks. Alexithymic and nonalexithymic patients were compared on the HAM-D scores, TAS-20 scores, and rate of response to antidepressant medication. The rate of responders, defined by a reduction of >50% from baseline in HAM-D total score, was 21.9% in the alexithymic group and 54.5% in the nonalexithymic group. Changes in the HAM-D scores were significantly correlated with the TAS-20 scores. TAS-20 scores dropped below 61 in only 31.2% of the alexithymic patients, and 68.8% of patients remained alexithymic. Whereas 50% of patients whose TAS-20 scores dropped below 61 responded to antidepressant medication, this rate was only 9.1% among patients who remained alexithymic. These findings indicated that the stability of alexithymic features had a negative effect on antidepressant treatment in depression.