Abstract
Copper may be involved in the pathophysiology of depression. Clinical data on this issue are very limited and not conclusive. The purpose of the study was to determine the copper concentration in the serum of patients with major depressive disorder and to discuss its potential clinical usefulness as a biomarker of the disease. A case–control clinical study included 69 patients with current depressive episode, 45 patients in remission and 50 healthy volunteers. Cu concentration was measured by electrothermal atomic absorption spectrometry (ETAAS). The mean serum copper level in depressed patients was slightly lower (by 11 %; not statistically significant) than in the control group. Furthermore, there was no significant difference in Cu2+ concentration between depressive episode and remission, nor between remission and control group. In the remission group were observed significant correlations between copper levels and the average number of relapses over the past years or time of remission. There was no correlation between serum copper and severity of depression, as measured by HDRS and MADRS. The obtained results showed no significant differences between the copper concentration in the blood serum of patients (both with current depressive episode and in remission) and healthy volunteers, as well as the lack of correlations between the copper level in the active stage of the disease and clinical features of the population. Our study is the first conducted on such a large population of patients, so the results may be particularly important and reliable source of knowledge about the potential role of copper in depression.
Highlights
Copper (Cu) is the third most abundant trace metal present in every tissue and is required for essential body functions
All of the patients were treated according to current guidelines using the following drugs: selective serotonin reuptake inhibitors (SSRI), serotonin–norepinephrine selective inhibitors (SNRI), tricyclic antidepressants (TCA), or mirtazapine, except that some patients were treated with atypical antipsychotic drugs, lithium or lamotrigine to potentiate antidepressant therapy
The analysis of correlation between the copper levels and the severity of depression showed no significance regardless of the subsample (Table 3). In this case–control study we found that the mean serum copper levels in patients with the depressive episode did not significantly differ from those obtained in healthy volunteers samples
Summary
Copper (Cu) is the third most abundant trace metal (behind iron and zinc) present in every tissue and is required for essential body functions. As a cofactor for numerous enzymes, it plays an important role in the biochemical processes, including erythropoiesis, cellular respiration, peptide amidation, iron, cholesterol and glucose metabolism, pigment formation, and hormones biosynthesis (see [1] for review). These metal ions are necessary for the proper development and functioning of the central nervous system; low copper level may result in incomplete development, while excess concentration maybe injurious [2]. Large quantities are synthesized primarily in the liver and kidneys and their production is dependent on availability of the dietary minerals [8]
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