Raised plasma levels of tumor necrosis factor α in patients with depression -: Normalization during electroconvulsive therapy

Objective: To examine whether electroconvulsive therapy (ECT) could modulate tumor necrosis factor (TNF)alpha levels in patients with depressive disorders. Method: Plasma levels of TNFalpha were analyzed in 23 depressed patients, mainly with severe depressive disorders, and in 15 sex- and age-matched healthy controls. Fifteen depressed patients were followed longitudinally with measurement of TNFalpha before, during, and after repeated ECT treatment. For comparison, TNFalpha levels were also analyzed longitudinally in the 8 depressed patients not receiving ECT. Results: Patients with depressive disorders had markedly raised TNFalpha levels compared with healthy controls. The clinical improvement during repeated ECT was accompanied by a gradual and significant decline in TNFalpha level, reaching levels comparable with those in healthy controls at the end of the study. Such a decline was not seen in the depressed patients not receiving ECT, who instead showed raised TNFalpha levels throughout the study period. Conclusion: Our findings support an association between inflammation and TNFalpha in particular and severe depression, and suggest that ECT may down-regulate this immune activation.