Depression drugs work better if young patients have inflammation

In a new study, researchers found that children and teens with bipolar depression responded better to an antipsychotic medicine if they had increased markers of inflammation in their blood.

The study suggests that C-reactive protein, a sign of systemic inflammation in the body that shows up in a readily available blood test, could be a predictive biomarker for identifying which patients with depression will respond to medication.

The research was conducted by a team at the University of Wisconsin–Madison.

Inflammation is known to be associated with mood disorders in adults, but this is one of the first findings to show that it can also predict antidepressant response in teens and children.

The study looked at 347 children and teens ages 10 to 17 with pediatric bipolar disorder who were experiencing a depressive episode.

About half were given drug lurasidone and the other half were given a placebo. Antipsychotics are a class of drugs used to manage bipolar disorder.

After six weeks, those who received the drug and showed the greatest improvement in depression symptoms also had the highest levels of C-reactive protein in their blood at the beginning.

However, the relationship only held for patients who were normal weight or underweight.

Those with a body mass index (BMI) in the overweight or obese range with higher levels of C-reactive protein showed little difference in response between the drug and the placebo.

The authors suggest that this finding might be explained by the fact that inflammation in obese and overweight children and teens is more closely related to their body mass and metabolism rather than specifically related to the types of inflammatory processes that are known to increase the risk for developing depression.

The lead author of the study is Charles Raison, professor of human development and family studies in the UW–Madison School of Human Ecology.

The study is published in Brain, Behavior, and Immunity.

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