Chronic Supplementation of Curcumin Enhances the Efficacy of Antidepressants in Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.

Major depressive disorder is a devastating mental illness leading to a lifetime prevalence of higher than 16% on individuals. The treatment delay and inevitable adverse effects are major limitations of current depression interventions. Emerging evidence indicates that curcumin produced significant antidepressant properties in depression in both rodents and humans without adverse effects. Therefore, it is necessary to further clarify the antidepressant actions of curcumin and the underlying mechanism in depressed patients. A total of 108 male adults aged between 31 and 59 years were systematically recruited in Tianjin Anding Hospital. Subjects were administered the Chinese version of 17-item Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale that measures different scores of depressive symptoms. The subjects were asked to take 2 capsules containing either 1000 mg of curcumin or placebo soybean powder daily for 6 weeks on the basis of their current antidepressant medications. The plasma levels of interleukin 1ß, tumor necrosis factor α, brain-derived neurotrophic factor, and salivary cortisol were measured by enzyme-linked immunosorbent assay before and after curcumin or placebo treatment during the 6-week procedure. Chronic supplementation with curcumin produced significant antidepressant behavioral response in depressed patients by reduction of 17-item Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale scores. Furthermore, curcumin decreases inflammatory cytokines interleukin 1ß and tumor necrosis factor α level, increases plasma brain-derived neurotrophic factor levels, and decreases salivary cortisol concentrations compared with placebo group. These findings indicate the potential benefits of further implications of supplementary administration of curcumin to reverse the development of depression and enhance the outcome of antidepressants treatment in major depressive disorder.

Inhibition of calcineurin in the prefrontal cortex induced depressive-like behavior through mTOR signaling pathway.

RATIONAL: Although it has been recognized that inhibition of calcineurin induced depressive-like behavior, the underlying neural mediators have not yet been identified. Mammalian target of rapamycin (mTOR), a serine/threonine protein kinase that regulates protein synthesis in synapses, has been demonstrated to be involved in the rapid antidepressant effects of ketamine. OBJECTIVE: To investigate a potential role of mTOR signaling pathway which interferes with depressive-like behavior induced by calcineurin blockade and to determine the neurobiological mechanisms underlying mood-related disorders. METHODS: Calcineurin inhibitor cyclosporine A (CsA) and tacrolimus (FK506) were microinjected into the medial prefrontal cortex (mPFC) in rats, and the depressive-like behavior was measured in sucrose preference test and forced swim test. Additionally, mTOR activity was tested by the levels of phosphorylation of p70s6 kinase (p70s6k) and 40S ribosomal protein S6 (rps6). RESULTS: Chronic microinjection of CsA or FK506 into mPFC increased depressive-like behaviors and decreased mTOR activity, but acute CsA or FK506 had no effects on both behavioral phenotype and mTOR activity. Furthermore, activation of mTOR by NMDA reversed the depressive-like behavior induced by chronic CsA or FK506 administration. Moreover, inhibition of mTOR by rapamycin reversed the antidepressant effects of ketamine. Finally, traditional antidepressant venlafaxine prevented the depressive-like performance induced by chronic CsA or FK506 treatment. CONCLUSION: These findings indicate that calcineurin-inhibition-induced depressive-like behavior is mediated by blockade of the mTOR signaling pathway and raise the possibility that stimulation of specific brain mTOR may be sufficient to decrease risk of affective disorders in patients treated with calcineurin inhibitor.