Short Communication Elmer Press J Clin Med Res • 2009;1(5):290-291 Effect of Escitalopram on White Blood Cells in Patients With Major Depression Fatih Canana, b, Ahmet Ataoglua Abstract Background: Immunological dysfunctions in the course of depres- sion are recently intensively investigated. Pharmacotherapy of de- pression is speculated to affect immune response. In this study, our objective was to investigate whether escitalopram treatment would affect white blood cells in patients with major depression. Methods: Fifteen patients (11 women and 4 men), meeting the criteria for a current episode of major depressive disorder, were par- ticipated. White blood cell (WBC), neutrophil (NEUT), lympho- cyte (LYMPH), monocyte (MONO), eosinophyl (EO), and baso- phyl (BASO) levels were measured at the entry to the study. After 8 weeks of open-label treatment with the selective serotonin reuptake inhibitor escitalopram (10-20 mg/d), the patients were readmitted and the measurements were repeated. Results: At the end of the study, LYMPH was found to be signifi- cantly decreased compared to the baseline value after 8 weeks treat- ment with escitalopram (p < 0.001). There was not a significant change in WBC, NEUT, MONO, EO, and BASO parameters. Conclusions: The present study has shown that escitalopram in- creased LYMPH in patients with major depression according to these results, the possible treatment of depression with escitalo- pram must be carried out with caution, in patients with immuno- logical disturbances. Keywords: Escitalopram; Major depression; White blood cells Introduction Immunological dysfunctions in the course of depression are Manuscript accepted for publication May 27, 2009 aDuzce University School of Medicine, Department of Psychiatry, Duzce, Turkey bCorresponding author: fatihcanan@gmail.com doi:10.4021/jocmr2009.12.1275 recently intensively investigated, but the results are inconsis- tent, possibly due to etiological variability of depression [1]. Both immunosuppression and pathological activation, simi- lar to that observed in inflammation or autoimmune diseases, were reported [1, 2]. It has been demonstrated that pharma- cotherapy of depression results in normalization of some disturbed indices of immunoreactivity [2]. In this study, our objective was to investigate whether escitalopram treatment would affect white blood cells in patients with major depres- sion. Patients and Methods The study was conducted in an outpatient clinic from April 2008 through August 2008. Fifteen patients (11 women and 4 men), meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for a cur- rent episode of major depressive disorder (MDD) (age, mean ± SD, 37 ± 10 years) were recruited. The eligible patients were physically healthy, aged 18 years or older. All of them had a baseline Montgomery-Asberg Depression Rating Scale (MADRS) [3] total score of at least 22. White blood cell (WBC), neutrophil (NEUT), lymphocyte (LYMPH), mono- cyte (MONO), eosinophyl (EO), and basophyl (BASO) lev- els were measured at the entry to the study. Blood samples were drawn after a fasting period of 12 h. They were obtained on the morning before starting the first dose of escitalopram. After 8 weeks of open-label treatment with the selective se- rotonin reuptake inhibitor escitalopram (10-20 mg/d), the patients with depression were readmitted and the measure- ments were repeated. All the patients were newly diagnosed and were not treated for depression previously. Written, in- formed consent was obtained, and the Ethics Commitee of Duzce University, Medical School Local Ethical Commitee for Clinical and Laboratory Studies, Turkey approved the study protocol. The study was conducted in accordance with the Declaration of Helsinki. Statistical analysis was done by SSPS statistical software (SPSS for windows 15.0, Inc., Chicago, IL, USA). Data were tested for normal distribution using the Kolmogorov–Smirnov test. Paired t-test was used to determine whether there was a significant difference be- 290 Articles © The authors, Journal compilation © J Clin Med Res and Elmer Press™, www.jocmr.org