Escitaloprams effects differ among major depressive disorder (MDD) patients, and approximately one-third of patients fail to respond. This poor antidepressant response might be due to excessively high C-reactive protein (CRP) levels, but the impact is unclear. A recent study hypothesized that in adults with major depressive disorder, the peripheral biomarker, CRP, is associated with the response to Escitalopram (SSRI).

This prospective follow-up study treated 71 patients with escitalopram for 12 weeks. It collected the Blood samples at baseline and week 12. It defined remission as a score of 7 or less on the HAMD-17 scale at week 12. 

The study employed Spearman correlations and multiple linear regressions to explore the relationship between continuous CRP levels and the HAMD-17 scores; and used Logistic regression to determine the predictors for remission. Further, it used the restricted maximum likelihood (REML)-based mixed-effect model for repeated measures (MMRM) to find the changes in the HAMD-17 total scores between high and low CRP groups.

The study found that contrasting the high CRP group (≥0.8 mg/l), the low baseline CRP group experienced a higher remission rate (22.73% vs. 48.89%). Patients with lower CRPs had 3.920 times more probability of remission. The HAMD-17 total score reduction (baseline to week 12) negatively correlated with the baseline CRP level.

This study suggested a predictive role of CRP for remission and symptomatic improvement after escitalopram treatment of MDD patients based on continuous or categorical CRP levels.

Journal of Affective Disorders. 2022;306:32-38. https://doi.org/10.1016/j.jad.2022.02.069.