Trial reportPsychoneuroendocrinology2017
Can C-reactive protein inform antidepressant medication selection in depressed outpatients? Findings from the CO-MED trial.
Trial report in Psychoneuroendocrinology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 100 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Combining Medications to Enhance Depression Outcomes
A Pilot Double-Blind Randomized Placebo-Controlled Crossover Study to Investigate Rapid Antidepressant Effects of Leucine
Who cites it
100 citing papers in PubMed, 3 syntheses or guidelines pooled it, 199 citations in OpenAlex.
- Cancer-related inflammation and depressive symptoms: Systematic review and meta-analysis.Cancer · 2022Pooled it
- Prevalence of low-grade inflammation in depression: a systematic review and meta-analysis of CRP levels.Psychological medicine · 2019Pooled it
- Replication and reproducibility issues in the relationship between C-reactive protein and depression: A systematic review and focused meta-analysis.Brain, behavior, and immunity · 2018Pooled it
- Sustained effects of repeated levodopa (L-DOPA) administration on reward circuitry, effort-based motivation, and anhedonia in depressed patients with higher inflammation.Brain, behavior, and immunity · 2025Trial
- Functional connectivity in reward circuitry and symptoms of anhedonia as therapeutic targets in depression with high inflammation: evidence from a dopamine challenge study.Molecular psychiatry · 2022Trial
- Pretreatment Reward Sensitivity and Frontostriatal Resting-State Functional Connectivity Are Associated With Response to Bupropion After Sertraline Nonresponse.Biological psychiatry · 2020Trial
- Sex differences in the association of baseline c-reactive protein (CRP) and acute-phase treatment outcomes in major depressive disorder: Findings from the EMBARC study.Journal of psychiatric research · 2019Trial
- Validating pre-treatment body mass index as moderator of antidepressant treatment outcomes: Findings from CO-MED trial.Journal of affective disorders · 2018Trial
- Proteomics profiling reveals inflammatory biomarkers of antidepressant treatment response: Findings from the CO-MED trial.Journal of psychiatric research · 2017Trial
- Platelet-Derived Growth Factor as an Antidepressant Treatment Selection Biomarker: Higher Levels Selectively Predict Better Outcomes with Bupropion-SSRI Combination.The international journal of neuropsychopharmacology · 2017Trial
- From case-control averages to validated subgroups: Interpreting inflammatory and neuroaxonal-injury biomarkers in schizophrenia and major depression.Brain, behavior, & immunity - health · 2026Review
- Kynurenine pathway metabolites are increased in inflammatory depression and decrease with omega-3 treatment.Brain, behavior, & immunity - health · 2026Article
- Characterizing Illness Course to Understand the Role of Inflammation on Brain Structure and Function in Individuals With Depression.Biological psychiatry · 2026Article
- Review
- Pharmaco-multiomics in major depressive disorder: a narrative review and proposed translational framework for difficult-to-treat and treatment-resistant depression.Frontiers in pharmacology · 2026Review
- Integrating multi-polygenic scores for enhanced prediction of antidepressant treatment outcomes in an East Asian population.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Stratifying the Inflamed Endotype in Difficult-to-Treat Depression: A Roadmap from Biomarkers to Precision Immunopsychiatry.Clinical neuropsychiatry · 2025Article
- Recent Change in Anhedonia, Major Depression and Low-Grade Inflammation: Dangerous Liaisons? A Study Based on a Cohort Referred for Polysomnography.Medicina (Kaunas, Lithuania) · 2025Article
- C-reactive protein is associated with pain-type somatic symptoms independent of mental health symptoms in adolescents: Evidence from the ALSPAC study.Brain, behavior, & immunity - health · 2025Article
- IL-8 and IL-1RA serum levels predicting depression treatment response in 6-week follow-up.Acta neuropsychiatrica · 2025Article
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveCurrently, no valid measures inform treatment selection for depressed patients. Whether C-reactive protein (CRP) in particular and two other acute phase reactants (inflammatory markers) could differentiate between patients responding to either of two treatments with different mechanisms of action was assessed.
methodSubjects included Combining Medications to Enhance Depression Outcomes (CO-MED) trial participants randomly assigned to either escitalopram plus placebo (SSRI monotherapy, n=51) or bupropion plus escitalopram combination (bupropion-SSRI combination, n=55) with baseline plasma samples. CRP, serum amyloid P component, and alpha-2-macroglobulin were measured using the Bioplex Pro™ human acute-phase 4-plex panel. We conducted mixed model analyses of depressive symptom (Quick Inventory of Depressive Symptomatology Self-Report) and side-effect burden (Frequency, Intensity, and Burden of Side-Effects Rating Scale) obtained weekly or every other week over the 12-week acute-phase of CO-MED trial to evaluate the relationship between these outcomes and baseline CRP and other acute-phase reactants.
resultsThe treatment arms did not differ in depressive symptom or side effect outcomes. Most participants (69.8%, 74/106) had baseline CRP levels greater than 1mg/L (indicative of systemic inflammatory activity). Higher baseline CRP levels were associated lower depression severity (correlation coefficient=-0.63) with bupropion-SSRI combination but not with SSRI monotherapy (correlation coefficient=0.40). The overall remission rate was 41.5%. The estimated remission rate with CRP threshold based assignment (SSRI monotherapy for <1mg/L and Bupropion-SSRI for ≥1mg/L) was 53.1%, with a number needed to treat of 8.6. Side effect burden was unrelated to any baseline inflammatory marker.
conclusionsBaseline CRP levels relate differentially to antidepressant treatment outcomes in persons with major depressive disorder. Clinicaltrials.gov identifier: NCT00590863.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.