DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20175690

Effect of Sertraline on biomarker alterations in patients of multidrug resistant tuberculosis with depression: a prospective clinical trial

Vijay Kumar Singh, Virendra Kushwaha, Pooja Agrawal, Ambrish Gupta, Amit Kumar, Dhananjay Chaudhari, Anand Kumar, Mahesh Chandra Bindal

Abstract


Background: Lipid profile parameters may be used as biomarker for depression. Sertraline belongs to selective serotonin reuptake inhibitors (SSRIs), the most commonly used group to treat the depression in multidrug resistant tuberculosis patients.

Methods: A prospective clinical trial was carried out in department of Psychiatry and department of Tuberculosis and Respiratory disease G.S.V.M. Medical College, Kanpur. Diagnosed MDR TB patients were screened for depression applying Hamilton Depression Rating Scale (HDRS) and these patients were referred to Psychiatrist for diagnosis of depression. Total 25 diagnosed patients of MDR TB with mild to moderate depression were selected. HDRS Score and morning blood sample of 5ml were collected to analyze biomarker for depression before intervention. Same test was repeated in 18 patients who completed the study at day 30 and 120 after administering Sertraline (50mg). Data were compiled and analyzed using SPSS 20.0 and paired t - test.

Results: The mean decrease in HDRS score from base line at day 30 and 120 of administering Sertraline were 6.22 (±1.26) and 2.72 (±0.67) which were significant (p˂0.001). The mean increase in serum cholesterol at day 30 was 153.94 (±19.31) and at day 120 was 157.83 (±19.36) which were significant (p˂0.001). Rest of Tg, HDLc, LDLc and VLDL cholesterole levels were not increased significantly.

Conclusions: As the depression symptoms improved by sertraline. The biomarkers of depression were also increased (within the normal range) from baseline but significant increase was observed in serum cholesterol only.


Keywords


High density lipoprotein, Low density lipoprotein, Sertraline, Serum cholesterol, Triglyceride

Full Text:

PDF

References


World Health Organization. WHO Global tuberculosis report; 2016:15-16. Available at: www.who.int/tb /publications /global_report/en. Accessed 25 September 2017.

TB India; 2017:9. Available at: tbcindia.gov.in/index1.php lang=1 andlevel=2 and sublinkid=4728andlid=3275. Accessed 24 September 2017.

Islam AT, Hoque A, Tarannum R. Pattern of psychiatric illness among tuberculosis Patients an analysis in a tertiary care hospital of Bangladesh. Int J Applie Resear. 2015;1(13):763-6.

Vega P, Sweetland A, Acha J, Castillo H, Guerra D, Smith FMC, et al. Psychiatric issues in the management of patients with multidrug resistant tuberculosis. Int. J Tuberc Lung Dis. 2004;8(6):749-59.

Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci. 2011;13:7-23.

Lykouras E, Ioannidis H, Voulgaris D. Depression in general hospital patients: preliminary results, Archives of Hellenic Medicine. 1987;4:287-9.

Pachi A, Bratis D, Moussas G, Tselebis A. Psychiatric Morbidity and Other Factors Affecting treatment adherence in pulmonary tuberculosis patients. Tuber Res Treat. 2013:489865.

Grimsley SR, Jann MW. Paroxetine, sertraline, and fluvoxamine: new selective serotonin reuptake inhibitors. Clin Pharm. 1992;11:930-57.

Jeffrey V, Amir HK. Generic Penetration in the Retail Antidepressant Market; Psychiatry (Edgemont). 2010;7(6):9-11.

Ghaemi SN, Shields GS, Hegarty JD, Godwin FK. Cholesterol levels in mood disorders: high or low? Bipolar Disord. 2000 Mar;2(1):60-4.

Golier JA, Marzuk PM, Leon AC, Weiner C, Tardiff K. Low serum cholesterol level and attempted suicide. Am J Psychiatry. 1995;152(3):419-23.

Parekh A, Smeeth D, Milner Y, Thuret S. The Role of Lipid Biomarkers in Major Depression Healthcare. 2017;5:5.

Terao T, Iwata N, Kanazawa K, Takano T, Takahashi N, Hayashi T, et al. Low serum cholesterol levels and depressive state in human dock visitors. Acta Psychiatr. Scand. 2000;101:231-4.

Gupta A, Jadhav A, Petkar S, Dubey V. Study of lipid derangement in pyschiatric disorder. Indian Med Gaz. 2013:253-56.

Deisenhammer EA, Kramer KR, Liensberger D, Kemmler G, Hinterhuber H. No evidence for an association between serum cholesterol and the course of depression and suicidality. Psychiatry Res. 2004;121:253-61.

Eker O, Ozsoy S, Eker B, Doğan H. Metabolic Effects of Antidepressant Treatment. Arch Neuropsychia. 2017;54:49-56.

Murat K, Ahmet T, Mine K, Muci E, Ihsan ME, Ersin Y. The effects of sertraline on blood lipids, glucose, insulin and HBA1C levels: A prospective clinical trial on depressive patients. J Resear Medic Scien. 2011;16:1735-6.

Beyazyüz M, Albayrak Y, Eğilmez O B, Albayrak N, Beyazyüz E. Relationship between SSRIs and Metabolic Syndrome Abnormalities in Patients with Generalized Anxiety Disorder: A Prospective Study. Psychia Investig. 2013;10(2):148-54.