Antidepressants Protect Against Dementia | News | Loyola Medicine
Wednesday, December 2, 2015

Antidepressant medication protects against blood compounds linked to dementia, Loyola study finds

MAYWOOD, Ill. – In addition to treating depression, a commonly used antidepressant medication also protects against compounds that can cause memory loss and dementia, a Loyola University Medical Center study has found.

The study found that blood levels of two neurotoxic compounds dropped significantly in depressed patients after they were treated with the antidepressant escitalopram (Lexapro®).

The study, published in the Journal of Psychiatric Research, provides new insights into how the immune system responds to depression.

Stress and depression interact in a vicious cycle. Stress can lead to depression in susceptible individuals. In turn, depression, if not treated, causes stress. This stimulates the body’s immune system to fight stress and depression, as it would a disease or infection. Revving up the immune system, which includes the inflammatory response, initially protects against stress. But over time, chronic inflammation can cause a range of health problems.

In this vicious cycle, depression can trigger an inflammatory response, which in turn can exacerbate depression, said Angelos Halaris, MD, PhD, lead author of the study and a professor in the Department of Psychiatry and Behavioral Neurosciences of Loyola University Chicago Stritch School of Medicine.

“It behooves us to diagnose depression early, treat it vigorously to achieve remission and work to prevent its relapse,” Dr. Halaris said.

The study compared 30 severely depressed patients with 27 healthy subjects. The patients were treated with escitalopram and followed for 12 weeks. Some patients dropped out of the study due to side effects of escitalopram or other reasons. Of the 20 patients who completed the entire study, 80 percent reported complete or partial relief from their depression.

To examine the inflammatory response, researchers measured blood levels of nine substances secreted by the immune system. At the beginning of the study, average levels of all nine of these substances were higher in the depressed patients than in the healthy subjects. The differences were statistically significant with four of these substances (hsCRP, TNFα, IL6 and MCP1).

The inflammatory response can lead to the production of neurotoxic compounds that can kill brain cells, leading to memory loss and dementia if the depression goes untreated or fails to respond adequately to treatment. The study found that among patients treated with escitalopram, levels of two neurotoxic compounds dropped significantly. Levels of 3-hydroxykynurenine fell by more than two-thirds between week 8 and week 12. Levels of quinolinic acid dropped 50 percent during the first eight weeks and were lower at the end of the study than at the beginning.

Escitalopram belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It’s possible that other SSRIs, such as Prozac®, Paxil® and Zoloft®, also could protect against neurotoxins, but this would have to be confirmed with other studies, Dr. Halaris said.

The study is limited by the small number of subjects. But it should stimulate interest in replicating the findings with larger groups over a longer period of time, researchers wrote.

The study is titled “Does escitalopram reduce neurotoxity in major depression?”

In addition to Dr. Halaris, other co-authors are Vidushi Savant, MD, Edwin Meresh, MD, Debra Hoppensteadt, PhD, Jawed Fareed, PhD, and James Sinacore, PhD, of Loyola; Aye-Mu Myint, MD, PhD of the University of Munich; and Edwin Lim, PhD, and Gilles Guillemin, PhD, of the Australian School of Advanced Medicine.

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About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.