Objectives: To evaluate quantitative results of serotonin plasma concentrations in generalized tonic-clonic seizure patients with combined depression. Subjects and methods: A cross-sectional study of serotonin serum concentrations at T0 (start of study) and T8 (after 8 weeks of treatment) is the result of random selection of 88 out of 102 generalized tonic-clonic seizure patients with combined depression at Haiphong Psychiatric Hospital from April, 2013 to October, 2015.
Journal of military pharmaco-medicine n08-2017 QUANTITATIVE RESULT OF SEROTONIN PLASMA CONCENTRATIONS IN GENERALIZED TONIC-CLONIC SEIZURE PATIENTS WITH COMBINED DEPRESSIVE DISORDER Pham Van Thang*; Bui Quang Huy**; Ngo Ngoc Tan** SUMMARY Objectives: To evaluate quantitative results of serotonin plasma concentrations in generalized tonic-clonic seizure patients with combined depression Subjects and methods: A cross-sectional study of serotonin serum concentrations at T0 (start of study) and T8 (after weeks of treatment) is the result of random selection of 88 out of 102 generalized tonic-clonic seizure patients with combined depression at Haiphong Psychiatric Hospital from April, 2013 to October, 2015 Results: Serotonin in the average plasma concentration at time T0 was 42.30 ± 24.46 ng/mL, at the time T8 79.39 ± 67.87 ng/mL The relationship between serotonin serum and some generalized tonic-clonic seizures with combined depression such as: the mild depression was (47.69 ± 38.77 ng/mL) higher than the severe depression (37.06 ± 17.57 ng/mL) Conclusion: There is not difference in plasma serotonin levels with clinical manifestations of organic depressive disorder, duration of depression, duration of epilepsy * Keywords: Generalized tonic-clonic seizures; Depressive disorder; Serotonin concentration INTRODUCTION People with epilepsy often have accompanied depressive disorders Serotonin levels in plasma are thought to be associated with depressive disorder, and in depressed patients, these levels are markedly lower than those of normal people, sometimes as high as 30% In Vietnam, quantitative serotonin levels in epilepsy patients with depression have not yet been studied With such importance, the objectives of this study is: Evaluate quantitative results of serotonin plasma concentrations in generalized tonic-clonic seizure patients with combined depressive disorder SUBJECTS AND METHODS Subjects 88 inpatients with generalized tonic-clonic seizures who have depressive cormibined disorder, were treated at Haiphong Mental Hospital from April, 2013 to October, 2015 Methods Cross-sectional descriptive study - Use the diagnostic criteria G40.6 of ICD-10 (1992) for generalized tonic-clonic seizure section and diagnostic criteria F06.32 for organic depressive disorder * Haiphong Mental Hospital ** 103 Military Hospital Corresponding author: Bui Quang Huy (bshuy2003@yahoo.com) Date received: 10/08/2017 Date accepted: 21/09/2017 203 Journal of military pharmaco-medicine n08-2017 - Test serotonin concentrations in 88 patients with ELISA at time T0 (start of study) and T8 (after weeks of treatment) - The data was processed and analyzed on standa 12.0 program RESULTS AND DISCUSSION Table 1: Serotonin levels in generalized tonic-clonic seizure patients with combined depressive disorder at T0 and T8 Serotonin levels n Average value (ng/mL) Maximum value (ng/mL) Minimum value (ng/mL) T0 88 42.30 ± 24,46 139.74 24.61 T8 88 79.39 ± 67,87 407.67 25.68 Time p < 0.001 Serotonin levels at T0: 42.30 ± 24.46 ng/mL, while at T8: 79.39 ± 67.87 ng/mL, comparing these two times showed that serotonin level was higher and statistically significant (p < 0.001) (t = -5.12, p = 0.000) According to Dao Van Phan (1998), serotonin level in healthy human blood was about 0.06 - 0.22 µg/mL [1] Saldanha B.D et al (2009) researched on 40 depressed patients treated with fluoxetine, sertraline, citalopram and paroxetine and found that serotonin concentration in plasma before intervention was 73.75 ng/mL and increased to 127.93 ng/mL after intervention [4] Table 2: Relationship between serotonin levels and depressive disorder Evaluative index n = 88 Proportion (%) Serotonin level (ng/mL) Mild 7.95 47.69 ± 38.77 Moderate 62 70.45 43.30 ± 24.52 Severe 19 21.60 37.06 ± 17.57 Depressive disorder p F = 0.65; p = 0.5230 The highest of serotonin level was at mild depressive disorder group (47.69 ± 38.77 ng/mL) and the lowest of serotonin level was at severe depressive disorder group (30.06 ± 17.57 ng/mL) Analysis of ANOVA variance showed that serotonin level were not statistically significant (p > 0.05) (F = 0.65; p = 0.5230) Wulsin L.R et al (2009) found serotonin levels in patients presenting with depression were 139 ± 6.5 ng/mL, a history of depression of 120 ± 5.0 ng/mL and no history of depression 119 ± 3.1 ng/mL [6] 204 Journal of military pharmaco-medicine n08-2017 Table 3: Relationship between serotonin levels in plasma and classification of depressive disorder Evaluative index n = 88 Proportion (%) Serotonin level (ng/mL) Depressive episode (F32) 81 92.05 42.62 ± 25.25 Recurrent depressive disorder (F33) 7.95 38.52 ± 12.29 Classifications of depressive disorder p t = 0.4241; p = 0.6726 Serotonin plasma concentrations in patients with depressive episode were 42.62 ± 25.25 ng/mL with recurrent depressive disorder: 38.52 ± 12.29 ng/mL When comparing two groups, there was no significant difference (p > 0.05) (t = 0.4241; p = 0.6726) Ruljancic N et al (2013) studied the quantification of serotonin levels in platelets by immunoassay (ELISA), the result of self-deprecated depression: 176 ng/109 plt, suicidal ideation group: 227 ng/09 plt, control group: 502 ng/109 plt [5] Table 4: Relationship between serotonin plasma concentrations and duration of depressive disorder Statistic index n = 88 Proportion (%) Serotonin level (ng/mL) Over month to months 9.09 28.49 ± 1.80 Over months to months 29 32.95 37.45 ± 14.94 Over months to months 22 25.00 42.36 ± 26.06 Over months to 12 months 26 29.55 52.99 ± 32.25 > 12 months 3.41 32.81 ± 4.82 Duration of depressive disorder p F = 2.43; p = 0.0543 The highest serotonin level was 52.99 ± 32.25 ng/mL and the lowest serotonin level was 28.49 ± 1.80 ng/mL Analysis of single-element variance using the ANOVA method showed that there were no statistically significant differences (p > 0.05) (F = 2.43; p = 0.054) Vuong Van Tinh (2011) found no correlation between serotonin levels and the duration of disease in patients with severe depression Specifically, the duration ≤ 12 months: 4.00 ± 1.43 ng/mL, 13 - 24 months: 5.79 ± 2.68 ng/mL, 25 - 36 months: 3.3 ± 2.23 ng/mL, > 36 months: 5.60 ± 2.11 ng/mL [2] 205 Journal of military pharmaco-medicine n08-2017 Table 5: Relationship between serotonin concentration in plasma and duration of epilepsy Statistic index Duration of epilepsy n = 88 Proportion (%) Serotonin level (ng/mL) ≤ years 9.09 35.805 ± 24.26 - 10 years 9.09 45.74 ± 23.92 11 - 15 years 16 18.18 41.36 ± 27.28 16 - 20 years 18 20.45 37.51 ± 14.70 21 - 25 years 12 13.64 52.66 ± 32.14 26 - 30 years 7.95 34.54 ± 9.20 > 30 years 19 21.59 45.22 ± 28.36 p p = 0.3948 Plasma concentrations of serotonin was the highest in the group of 21 - 25 years (52.66 ± 32.14 ng/mL), and the lowest in group of 26 - 30 years (34.54 ± 9.20 ng/mL) When analyzing ANOVA variance, we found that the difference between groups was not statistically significant (p > 0.05) (p = 0.3948) We did not find direct comparative data with other authors on the relationship between serotonin plasma concentrations and time of epilepsy Arbatova J et al (2005) found that the plasma concentrations of tryptophan in the epileptic seizure with an average age of 33 ± years were (33.08 ± 3.2 µg) lower than those of the healthy controls (control group) (78.8 ± 4.4 µg) [3] CONCLUSION - Serotonin levels at time T0 was 42.30 ± 24.46 ng/mL and after weeks of treatment with fluoxetine in combination with antiepileptic drugs (at T8) was 79.39 ± 67.87 ng/mL 206 - Serotonin levels in plasma were the highest in mild depressive disorder (47.69 ± 38.77 ng/mL) and the lowest in severe depressive disorder (30.06 ± 17.57 ng/mL) - Serotonin levels in patients with depressive episode was 42.62 ± 25.25 ng/mL and with recurrent depressive disorder was 38.52 ± 12.29 ng/mL - There was no difference between serotonin level and duration of depression - There is no difference between serotonin level and duration of epilepsy REFERENCES Phan Van Dao Serotonin in: Pharmacology Medical Publishing House Hanoi 1998, pp.563-556 Vuong Van Tinh Research on clinical characteristics and related factors in patients with major depressive disorder Medical Doctorate thesis Vietnam Military Medical University 2011 Arbatova J, Amato E, Vaarmann A et al Reduced serotonin and 3-hydroxyanthranilic acid levels in serum of cystatin B-deficient mice, a model system for progressive myoclonus epilepsy Epilepsia 2005, 46 (5), pp.49-51 Saldanha B.D, Kumar M.N et al Serum serotonin abnormality in depression Medical Journal Armed Forces India 2009, 65, pp.108-112 Ruljancic N, Mihanovic M, Cepelak I et al Platelet serotonin and magnesium concentrations in suicidal and non-suicidal depressed patients Magnesium Research 2013, 26 (1), pp.9-17 Wulsin L.R, Musselman D, Otte C et al Depression and whole blood serotonin in patients with coronary heart disease from the heart and soul study PsychosomaticMedicine 2009, 71 (3), pp.260-265 ... on standa 12.0 program RESULTS AND DISCUSSION Table 1: Serotonin levels in generalized tonic- clonic seizure patients with combined depressive disorder at T0 and T8 Serotonin levels n Average value... 25.25 Recurrent depressive disorder (F33) 7.95 38.52 ± 12.29 Classifications of depressive disorder p t = 0.4241; p = 0.6726 Serotonin plasma concentrations in patients with depressive episode... after weeks of treatment with fluoxetine in combination with antiepileptic drugs (at T8) was 79.39 ± 67.87 ng/mL 206 - Serotonin levels in plasma were the highest in mild depressive disorder (47.69