Cholesterol concentrations and clinical response to sertraline in patients with epilepsy: Preliminary results

Abstract Objective Low cholesterol levels are associated with depression and suicide in persons with epilepsy. The goal of this study was to determine whether plasma cholesterol concentration is a predictor of response to sertraline. Methods We carried out a prospective open-label study on the efficacy of sertraline as therapy in the treatment of depressive disorder in patients with mesial temporal lobe epilepsy. Patients were treated for 24 weeks at dose levels between 50 and 100 mg/day. All patients were evaluated at the beginning of the investigation and 6 months later by two psychiatrists using a structured interview. Results The mean total cholesterol concentration of nonresponding patients was lower than the mean (SD) cholesterol level of responders [3.2 (0.9) mmol/L vs 5.2 (1.5) mmol/L]; this difference reached statistical significance ( P = 0.0000). We found a negative correlation between scores on the Hamilton scale and cholesterol concentrations ( r = –33). Conclusion The response to sertraline may depend on the baseline cholesterol concentration.