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Meta-Analysis
. 2017 May-Jun;49(3):236-242.
doi: 10.4103/ijp.IJP_700_16.

The impact of antidepressant treatment on brain-derived neurotrophic factor level: An evidence-based approach through systematic review and meta-analysis

Vijayakumar Arumugam  1 , Vini Susan John  1 , Nisha Augustine  1 , Taniya Jacob  1 , Sagar Maliakkal Joy  1 , Suchandra Sen  1 , Tuhinadri Sen  2
Affiliations
Meta-Analysis

The impact of antidepressant treatment on brain-derived neurotrophic factor level: An evidence-based approach through systematic review and meta-analysis

Vijayakumar Arumugam et al. Indian J Pharmacol. 2017 May-Jun.

Abstract

Objectives: Antidepressant treatment alters brain-derived neurotrophic factor (BDNF) levels, but it is not well established whether BDNF can be used as a marker to prove the efficacy of antidepressant treatment. The present systematic review and meta-analysis aim at assessing the influence of antidepressant treatment on BDNF level and the Hamilton Depression Rating Scale (HDRS) score, thereby to establish the rationale of utilizing BDNF as a predictive biomarker and HDRS score as an indicator for antidepressant treatment efficacy.

Materials and methods: Search was conducted in PubMed, Science Direct, and Cochrane databases using the key words "BDNF" and "Depression" and "Antidepressants." On the basis of the inclusion and exclusion criteria, studies were filtered and finally 6 randomized controlled trials were shortlisted.

Results: Comparison of serum BDNF level before and after antidepressant treatment was performed and the result showed that antidepressant treatment does not significantly affect the BDNF levels (confidence interval [CI]: -0.483 to 0.959; standard mean difference [SMD]: 0.238, P = 0.518). Egger's regression test (P = 0.455) and heterogeneity test (I2 = 88.909%) were done. Similarly, comparison of HDRS scores before and after antidepressant treatment indicated improvement in HDRS score suggesting positive outcome (CI: 1.719 to 3.707; SMD: 2.713, P < 0.001). Egger's regression test (P = 0.1417) and heterogeneity test (I2 = 89.843%) were performed. Publication bias was observed by funnel plot.

Conclusion: Changes in BDNF levels do not occur uniformly for all the antidepressants. Hence, to use BDNF as a biomarker, it needs to be seen whether the same is true for all antidepressants.

Keywords: Antidepressants; Hamilton rating scale for depression; brain-derived neurotrophic factor; depression; meta-analysis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Overview: Biomarkers of antidepressant treatment response. CRH, corticotropin-releasing hormone; CYP = Cytochrome P450, Dex = Dexamethasone, FKBP5 = FK506-binding protein 5, IGF-1 = Insulin-like growth factor 1, QEEG = Quantitative electroencephalographic, rACC = Rostral anterior cingulate cortex, REM = Rapid eye movement, VEGF = Vascular endothelial growth factor
Figure 2
Figure 2
Diagram of literature search and trial selection process
Figure 3
Figure 3
Forest plot that shows the association of derived neurotrophic factor level in major depressive disorder patients before and after antidepressant treatment using random effect model. The pooled standard mean difference is represented by a diamond plot of standard height, with the width indicating 95% confidence interval
Figure 4
Figure 4
Forest plot that shows the association of Hamilton Depression Rating Scale scores in major depressive disorder patients before and after antidepressant treatment using random effect model. The pooled standard mean difference is represented by a diamond plot of standard height, with the width indicating 95% confidence interval
See this image and copyright information in PMC

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