Abstract

Aim: Depression is a frequently accompanying disorder in multiple sclerosis (MS). The role of the inflammatory nature of the illness on developing depression in MS has been studied. Recently most of the authors have been concentrated on the similarities between the cytokines playing a role in the etiopathogenesis of MS and depression. The aim of the study was to find out the relationship between depression and cytokines and the effect of antidepressant therapy on cytokins in patients with in relapsing remitting MS (RRMS) having mild to moderate depression. Methods: The study included 36 RRMS patients with depression ages between 18-59 and 24 controls within similar ages. RRMS+ depression patients were evaluated in three groups: Group 1: Patients treated with IFN-Beta lb and antidepressant agent, Group 2: Patients treated vuith pentoxyphilin and antidepressant agent, Group 3: RRMS patients treated with only antidepressant agent. The control group included Group 4 (n=12): Patients with depression only and taking an antidepressant drug, and Group 5 (n=12): Healthy controls. Paroxetine was the antidepressant drug used in all patients with depression. Depression was diagnosed by psychiatric observation and psychometric test performed by a psychiatrist. The initial and post-treatment (3rd and 6th months) IL-1 beta, IL-2, IL-6, IFN-gama, TNF-alfa levels were assesed by ELISA in all the patients. Statistical analysis was performed by using one way and repeated measure ANOVA, paired t-test and Bonferoni tests. P< 0.005 was accepted as statistically significant. Results: IL-2 and IFN-y levels were significantly higher in the MS study groups (Group 1-3) and patients with depression (Group 4) than compared to healthy controls (Group 5)(p<0.05). IL-2 and IFN-y levels decreased significantly in all groups except the healthy control group after a 6 months treatment (p<0.05). The most significant decrease in IFN-y levels was observed in the group taking interferon beta 1b treatment. Conclusion: When the fact that both cytokines play a proinflammatory role in the pathogenesis of MS is taken into account, the significantly high levels of IL-2 and IFN-y in all the cases having depression are considered very meaningful. The observation that these high levels decline by antidepressant therapy suggests that the changes in the psychic status of MS patients should be followed carefully and depression developing in MS may be related to inflammatory cytokines.