Tuesday, September 17, 2013

The Role of Inflammation in Depression and its Treatment



Dr. Charles Raison, MD of the University of Arizona is an Associate Professor of Psychiatry and Family and Consumer Sciences.  He has also been a speaker with “Ted Talks.”  Today (09/17/13), he gave a talk at the Levy Cancer Center called, “Coming to Our Senses: Implications of Embodiment or the Pathogenesis and Treatment of Major Depression.”  In his research dedicated to the treatment of depression, he discovered a direct correlation between depression and inflammation.  Furthermore, he found that in those with depression whose inflammation was greatest, the treatment outcome was best.

Dr. Raison explained he used different treatment methodologies to demonstrate his theory, that without treating the brain directly for depression, subjects would have improvements in their depression.  In one experiment, he placed subjects in a whopping 140-degree vessel for two hours, with their heads outside the heated chamber.  Depressed patients tend to have high core body temperatures and sweat very little.  He believed the outcome for this first treatment was that the brain “reset” the core temperature, and with the system running cooler, depression diminished. 

In another, he treated patients with “a potent anti-inflammatory,” similar to the brand “Humira,” or with placebo.  He was excited to see that half of the patients treated had diminished depression.  The twist, however, was that one-quarter of the patients were from the anti-inflammatory-treated group, while one quarter were from the placebo group.  Those subjects in either of the two experiments whose outcomes were best, were those whose level of inflammation was highest at the beginning of the treatment period. 

3 comments:

  1. Whoa, this is really interesting! I am assuming that we are talking about inflammation of the brain, but correct me if I am wrong. I wonder how the heat vessel actually 'resets' the body's core temperature to a cooler setting. Plus, is this setting back to the normal 98.6 or is it even cooler than that? This also leads me to question why the inflammation was treated with heat. When I think about injuries, we usually are told to put ice/cold temperatures on it to restrict blood flow and therefore prevent more inflammation and swelling.

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  2. There was a study done about the correlation between C-RP and depression "Elevated C-Reactive Protein Levels, Psychological Distress, and Depression in 73 131 Individuals" Maybe checking C-RP levels is not as useless as previously thought. Perhaps there is a use for C-RP as a diagnostic for which method of treatment might be best for a depressed patient.

    http://archpsyc.jamanetwork.com/article.aspx?articleid=1485898

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  3. In response to Sarah Batterton, the body resets by exposure to the higher temperature. The body is heated beyond that to which it is accustomed and normally does not respond to under depressive conditions. Eliciting a response to the higher heat helps the body whose thermostate was "stuck" by allowing a response. The body then resets to a cooler core temperature.

    In response to Robert Peterson, CRP is not really "useless," howevr the benefit of its use for evaluating and monitoring inflammatory disease can be found within the context of establishing a baseline and seeing deviations. Even these deviations must be placed in the context of other immune-response-stimulating events, such as large acid load consumption, exposure to colds and flus.

    Let me know if you have any questions, and thank you for your comments!

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