Do Benzodiazepines Plus Fluvoxamine Cause a Rapid Increase in Serum Brain-derived Neurotrophic Factor or Clinical Improvement in Major Depressive Disorder Patients?Author(s): Asuka Katsuki, Yoshihisa Fujino, Hoa Le Nguyen, Reiji Yoshimura
Objective: Benzodiazepines are sometimes co-prescribed with antidepressants for patients with major depressive disorder (MDD) who have symptoms such as sleep disturbance, restlessness, or anxiety. The aim of the present study was to examine whether serum levels of brain-derived neurotrophic factor (BDNF) differed between patients with MDD treated with fluvoxamine alone and those treated with a fluvoxamine and benzodiazepine combination.
Methods: Twenty-eight first-episode patients with MDD were enrolled in the present study. Thirteen patients were male, and 15 were female, with ages ranging from 29 to 70 (mean ± standard deviation [SD], 47.9 ± 11.6) years. All the patients met the DSM-5 criteria for MDD; were physically healthy; and were free of alcohol or drug abuse, comorbid anxiety, or personality disorders at the time of the study. The patients were administered fluvoxamine monotherapy for eight weeks at doses that varied among the patients and were not fixed for ethical reasons. In the benzodiazepine co-administration group, the dose of benzodiazepines was kept constant during the experimental period. Depression was assessed using the Structured Interview Guide for the 17-item Hamilton Depression Rating Scale (HAMD17). Serum BDNF and plasma fluvoxamine levels were measured.
Results: The HAMD17 scores in all subjects were significantly decreased after treatment with fluvoxamine. No significant difference was found between the two groups (fluvoxamine versus fluvoxamine and benzodiazepines) regarding the reduction in HAMD17 scores. Serum BDNF levels in all subjects were significantly increased after treatment with fluvoxamine. No difference was observed between the groups regarding the increase in serum BDNF levels.
Conclusion: These results suggest that benzodiazepine co-administration did not influence serum BDNF levels or clinical improvement in MDD patients.