2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification
- Small blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate)Note: hsCRP (high-sensitivity CRP) is significantly elevated in patients with major depression compared with healthy controls.
- Urine status (rapid test for: protein, glucose, ketone, urobilinogen, bilirubin).
- Fasting glucose (fasting blood glucose).
- HbA1c
- Thyroid parameter – TSH (thyroid-stimulating hormone) – to exclude hypothyroidism (underactive thyroid).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance if necessary; microalbuminuria test.
- Vitamin B12 and folic acid
- Vitamin D (25-OH vitamin D)
- HIV antibody test
- TPHA (Lues serology)
- CSF examination
- Antidepressant serum levels (compliance?)
Further notes
- There appears to be a significant relationship between serum CRP levels at baseline and treatment response:
- CRP levels >1 mg/l: remission in 51% of subjects receiving combination therapy compared with 33% receiving monotherapy.
- CRP levels < 1 mg/l: remission in 57% of subjects on monotherapy compared with 30% who were on combination therapy.
- The hsCRP (high-sensitivity CRP) is significantly increased in patients with major depression compared with healthy controls.
Further studies must now show whether these results can also be applied to different types of depression and other antidepressants.
