First AD

Second AD

A. Inflammation has specific effects on neurotransmitters and neurocircuits in the brain

B. Monocytes are attracted to the brain during stress

C. Depression is not an inflammatory disorder

D. Anti-cytokine medications have been shown to be effective antidepressants for patients with major depression

Cytokine inhibitors have not been shown to be effective antidepressants for patients with major depression. If future research supports the idea that the pathophysiologic process emanates from the periphery and spreads to the brain, blood tests might be able to identify specific individuals for treatment targeting and ultimately precision care.

Inflammatory markers alone or in combination have been shown to predict treatment response to conventional antidepressants and psychotherapy as well as advanced treatment strategies such as ketamine and anti-cytokine immunotherapy.

 Unfortunately, these studies are post hoc in nature, and no study has yet to prospectively assign patients with one or more level of inflammatory marker to a given treatment and predict response.

It is important to note that depression is not an inflammatory disorder. However, increased inflammation does occur in depression. It is also present in in multiple other psychiatric diseases including bipolar disorder, anxiety disorders, personality disorders, and schizophrenia. These data suggest that inflammation is transdiagnostic in nature, occurring in subpopulations of patients within a number of psychiatric disorders.

Five Things to Know About Inflammation and Depression

The role of inflammation in depression: from evolutionary imperative to modern treatment target

Therapeutic implications of brain-immune interactions: treatment in translation

Major Depressive Disorder

Quizzes

Because immunologic processes connected to psychiatric disorders have received considerable attention, we invite you to test your knowledge on the pathophysiologic process of depression and inflammation.

Mini Quiz: Inflammation and Psychiatric Disorders

Andrew H. Miller, MD