Brief reportSerum zinc level in depressed patients during zinc supplementation of imipramine treatment
Introduction
Depression is considered as a chronic and recurring illness. The development of new medications for depression has been hindered by an insufficient knowledge on the pathophysiology of this disorder (Skolnick et al., 2009). Among other factors, a major obstacle in the diagnosis and effective therapy is the lack of biomarkers allowing assessment of the current depressive state. The discovery of such a marker could also be useful in predicting the risk of development of the disease and/or its relapse as well as its resistance to treatment. Some potential candidate markers of depression have been reported [e.g. (Dinan, 2009, Piccinni et al., 2009, Maes et al., 2010], but their relationships to the mechanisms of the pathophysiology of depression and efficacy in clinical practice are at present unclear.
Current hypotheses of depression are based on the alteration of neurotransmission, yet mostly of the monoaminergic and amino-acidergic systems (Skolnick et al., 2001, Palucha and Pilc, 2005, Pilc and Nowak, 2005). Recent data points to the involvement of zinc – a modulator of glutamatergic neurotransmission – in mood disorders and in the mechanism(s) of antidepressant activity (Nowak et al., 2005, Szewczyk et al., 2008, Szewczyk et al., 2010b). Preclinical studies have demonstrated the antidepressant-like activity of zinc in animal tests and models (Cieslik et al., 2007, Kroczka et al., 2000, Kroczka et al., 2001, Nowak et al., 2003b, Rosa et al., 2003, Sowa-Kucma et al., 2008). Moreover, zinc has been shown to enhance the activity of antidepressant drugs (Cieslik et al., 2007, Cunha et al., 2008, Kroczka et al., 2001, Szewczyk et al., 2002, Szewczyk et al., 2009), while zinc deficiency produced depressive-like alterations in behavioral and neurochemical studies (Corniola et al., 2008, Takeda and Tamano, 2009, Tassabehji et al., 2008, Whittle et al., 2009). Some clinical studies have indicated the reduction of the blood zinc level in depressed patients (Amani et al., 2010, Maes et al., 1994, Maes et al., 1997a, McLoughlin and Hodge, 1990, Nowak et al., 1999). Our previous clinical study demonstrated that zinc enhanced antidepressant efficacy in, especially, treatment-resistant patients suffering from major depression (Nowak et al., 2003a, Siwek et al., 2009).
The present study examined the effect of zinc supplementation to imipramine treatment on the serum zinc level in depressed patients.
Section snippets
Subjects
Sixty patients admitted to the Department of Psychiatry Jagiellonian University Collegium Medicum or to the Affective Disorder Outpatients Unit and fulfilling the DSM-IV criteria for major depression were accepted for the study [18–55 years old, details described previously (Siwek et al., 2009)].
A group of 25 healthy volunteers (normal controls) was also recruited. The normal controls (18–55 years old) were free of mental disorders and had no family history of depression or mania. In the normal
Results
The characteristics of the patients and the effect of the treatment on their psychopathological status were previously published by Siwek et al. (2009). The mean ages (± SD) in the volunteers and patients were 43 ± 9.1 and 45.9 ± 5.9 years, respectively, and did not significantly differ (P = 0.08). There were no significant differences in the female/male ratio between the volunteer (16/9) and patient group (40/20) (P = 0.81).
The analysis of zinc concentrations with ANOVA (Fig. 1) revealed that all of the
Discussion
The present study reports the first analysis of the changes in the serum zinc level in depressed patients receiving zinc supplementation of the uniform treatment regime (imipramine + placebo or zinc). All previous studies enrolled patient groups treated with various antidepressant drugs and a combination therapy (McLoughlin and Hodge, 1990, Schlegel-Zawadzka et al., 2000, Maes et al., 1996, Maes et al., 1997b, Maes et al., 1999).
The fact that significantly lower serum zinc concentrations existed
Role of funding source
This study was partially supported by Grant POIG 01.01.02-12-004/09, Funds for Statutory Activity of the Institute of Pharmacology, Polish Academy of Sciences and Jagiellonian University, Kraków, Poland, but had no further role in the study design, in the collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the paper for publication.
Conflict of interest
The authors have no conflict of interest.
Acknowledgement
Authors thank “Farmapol” Sp. z o.o., Poznań, Poland for the generous gift of Zincas and placebo.
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