Effects of sertraline on depressive symptoms, serum brain-derived neurotrophic factor (BDNF), 5-HT, and inflammatory cytokine expression in pediatric depression patients.

Abstract

This study investigated the therapeutic effects of sertraline in pediatric patients diagnosed with depression, focusing on its impact on serum levels of brain-derived neurotrophic factor (BDNF), serotonin (5-HT), and inflammatory cytokines. A total of 164 pediatric patients were randomly divided into two groups: the sertraline and control groups, with 82 participants in each. Depressive symptoms were evaluated at 2 and 4 weeks using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Children's Depression Rating Scale-Revised (CDRS-R). Serum concentrations of BDNF, 5-HT, and inflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor-α) were quantified using ELISA. Results demonstrated no significant differences in baseline characteristics between the groups. After 4 weeks, both groups showed reductions in HAMD-17 and CDRS-R scores and interleukin-1β and tumor necrosis factor-α levels, as well as increases in BDNF and 5-HT levels. Notably, at the 2-week mark, the sertraline group had significantly lower scores in both depression scales and inflammatory cytokines compared to the control group (fluoxetine treatment), indicating an early onset of action. Despite these findings, by 4 weeks, differences in HAMD-17 and CDRS-R scores, BDNF, and 5-HT levels between the two groups were no longer significant, although the sertraline group maintained lower levels of inflammatory cytokines. Additionally, the sertraline group reported higher rates of early improvement and adverse events, though no significant differences in remission or response rates were found between the groups. Overall, sertraline demonstrates effectiveness in alleviating depressive symptoms in children during the initial treatment period, potentially via mechanisms involving BDNF, 5-HT, and inflammation modulation, although it presents a less favorable safety profile compared to fluoxetine. (PsycInfo Database Record (c) 2025 APA, all rights reserved).