Changes in acute-phase proteins during lithium potentiation of antidepressants in refractory depression

This study was performed on 32 patients with refractory depression in whom lithium was added to antidepressant treatment in order to potentiate the therapeutic effect, and in 20 healthy controls. Plasma concentration of three acute-phase proteins (APPs): C-reactive protein, alpha-1-acid glycoprotein (AGP) and alpha-1-antichymotrypsin (ACT) as well as microheterogeneity of AGP and ACT were measured, before and after 4 weeks of lithium addition to antidepressants. Before Li addition, all patients studied had elevated values of APPs, which suggested the existence of immunological activation. A significant decrease in plasma levels of all APPs and the decrease of glycosylation values of AGP and ACT was observed after Li potentiation. A favorable clinical effect of lithium potentiation after 4 weeks was found in 24 patients (75%). Nonresponders to Li potentiation differed from responsers by their immunological indices prior to Li addition. They had higher values of reactivity coefficients, which means more inflammatory patterns.