Low tumor necrosis factor‐α levels predict symptom reduction during electroconvulsive therapy in major depressive disorder

Objective Changes in the tumor necrosis factor‐α ( TNF α) have been associated with major depressive disorder ( MDD ). Findings concerning the effects of electroconvulsive therapy ( ECT ) on the TNF α level have been contradictory. The aim was to examine the immediate and long‐term changes in the TNF α level and their associations with symptom reduction in patients with MDD during ECT . Method The study included 30 patients with MDD . Their TNF α levels were measured at baseline and 2 and 4 hr after the first, fifth and last ECT session. Depressive symptoms were assessed with the Montgomery‐Asberg Depression Rating Scale ( MADRS ). Results The TNF α level decreased from baseline to the 2‐ and 4‐hr measurements. There was a correlation between the first ECT session TNF α levels and the relative symptom reduction according to the MADRS score after the ECT series. Both the first (baseline) ECT and 4‐hr TNF α levels were lower in responders than in nonresponders. Conclusion ECT consistently induced a decrease in the TNF α level after each studied session. A low TNF α level at the first ECT appeared to predict a symptom reduction. These findings suggest that TNF α might have a role in the pathogenesis in MDD and in the mechanism of action of ECT .