Abstract
Background Evidence indicates an association between immune dysregulation
and major depressive disorder (MDD). Pentoxifylline (PTX), a phosphodiesterase
inhibitor, has been shown to reduce pro-inflammatory activities. The aim of this
study was to evaluate changes in depressive symptoms and pro-inflammatory
markers after administration of PTX as an adjunctive agent to citalopram in
patients with MDD.
Methods One hundred patients were randomly assigned to either citalopram
(20 mg/day) plus placebo (twice daily) (n=50) or citalopram (20 mg/day) plus PTX
(400 mg) (twice daily) (n=50). The Hamilton Depression Rating Scale-17
(HAM-D-17) scores at baseline, weeks 2, 4, 6, 8, 10, and 12 and serum levels of
interleukin1-β (IL-1-β), tumor necrosis factor-α, C-reactive protein, IL-6,
serotonin, IL-10, and brain-derived neurotrophic factor (BDNF) at baseline and
week 12 were evaluated.
Results HAM-D-17 score in the PTX group significantly reduced in
comparison to the control group after weeks 4, 6, 8,10, and 12 ((LSMD): − 2.193,
p=0.021; − 2.597, p=0.036; − 2.916, p=0.019; − 4.336, p=0.005; and − 4.087,
p=0.008, respectively). Patients who received PTX had a better response (83%)
and remission rate (79%) compared to the placebo group (49% and 40%, p=0.006 and
p=0.01, respectively). Moreover, the reduction in serum concentrations of
pro-inflammatory factors and increase in serotonin and BDNF in the PTX group was
significantly greater than in the placebo group (p<0.001).
Conclusion These findings support the safety and efficacy of PTX as an
adjunctive antidepressant agent with anti-inflammatory effects in patients with
MDD.
Keywords
pentoxifylline - PTX - major depressive disorder - MDD - inflammation
