Comparison of Serum BDNF changes in Women with Major Depressive Disorder Treated with Fluoxetine and Cognitive Behavioral Therapy: A Randomized Clinical Trial

Abstract

Background and purpose: Major depressive disorder (MDD) is among the most common psychiatric diseases. Brain-derived neurotrophic factor (BDNF) is a suitable biomarker for treatment response. In the present research، serum changes of this biomarker were assessed between the two groups of MDD patients undergoing Fluoxetine therapy and cognitive-behavioral therapy (CBT). Materials and methods: In this randomized controlled trial study, 40 female MDD patients (DSM-V criteria) were assigned to two Fluoxetine therapy (20 mg/d for 3 months) (N=20) and CBT (90-minute sessions، once a week، for 12 weeks) (N=20) groups. The Beck Depression Inventory-II (BDI-II) score and serum BDNF concentration were measured before and after the treatment. The data were analyzed at a significance level of P≤0.05 using Graphpad prism 9 statistical software. Results: The BDI-II score significantly decreased in both Fluoxetine therapy (from 23.2±1.5 to 11.1±1.01) and CBT (from 26.8±0.6 to 9.5±0.8) groups. No significant change was observed in the serum BDNF level in the Fluoxetine therapy group، while it was increased in the CBT group (from 1.13±0.71 to 3 ± 0.72 ). The intergroup comparison after treatment indicated that the BDI-II score decrease and the serum BDNF increase were higher in the CBT group than in the Fluoxetine therapy group. Conclusion: The BDI-II score decrease and the serum BDNF increase were higher in the CBT group than in the Fluoxetine therapy group. Thus، it seems appropriate for MDD treatment. Serum BDNF is not an appropriate biomarker for treatment response. It is suggested that a study be conducted with a larger sample size and a longer investigation period. (Clinical Trials Registry Number: IRCT20190710044171N1)

Keywords

• bdnf
• cognitive behavior therapy
• fluoxetine
• major depressive disorder