Increased levels of Serum Nitrogen oxides are indicators of Post-treatment response in Mood disorder patients with Acute episodes

Author(s): Chih-Wei Hsu, Tiao-Lai Huang, Meng-Chang Tsai


Nitrogen Oxides (NOx) has an important role in mood disorders. This study aims to investigate whether serum NOx levels are associated with bipolar disorder, manic episodes (BD-ME) and major depressive disorder, depressive episodes (MDD-DE), and to evaluate the impact of treatments on NOx levels and symptoms severity in BD-ME and MDD-DE patients.


We enrolled 20 patients with BD-ME, 18 with MDD-DE, and 80 healthy subjects. Serum NOx levels were measured with assay kits. Symptom severity was evaluated using the Young Mania Rating Scale (YMRS) for BD-ME and the Hamilton Depression Rating Scale (HAM-D) for MDDDE. We collected and analyzed patients’ NOx, YMRS, and HAM-D data while pre-treatment (admission) and post-treatment (discharge).


Serum NOx levels of the healthy controls were higher than patients with BD-ME and lower than patients with MDD-DE, but the difference was not statistically significant. Serum NOx levels were both increased in BD-ME (p=0.0047) and in MDD-DE (p=0.0398) patients after treatment. The changes of NOx levels were not associated with the changes of YMRS scores in BD-ME patients after treatment. However, the changes of NOx levels were negatively correlated with the changes of HAM-D scores in MDD patients after treatment (p=0.0473).


Our results suggest that increased levels of serum NOx are indicators in patients with BDME and MDD-DE after treatment. In addition, the changes of serum NOx levels might be measuring biomarkers for assessment of treatment response in MDD-DE patients.

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