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Whole-body hyperthermia effective for depressive symptoms in MDD

Whole-body hyperthermia had antidepressant effects among adults with major depressive disorder, according to recent findings.

“Warm-sensitive thermosensory pathways projecting from the skin (and other epithelial linings) to specific subcortical and cortical regions may affect neural activity and behavior in ways relevant to the treatment of major depressive disorder (MDD). For example, in humans, exposure to cutaneous heating (41°C) activates the midorbitofrontal cortex, the pregenual anterior cingulate cortex, and the ventral striatum, with the degree of activation being associated with subjective pleasantness ratings made in response to the warm temperature,” Clemens W. Janssen, PhD, of University of Wisconsin, Madison, and colleagues wrote. “Importantly, these and other brain regions most implicated in registering — and reacting to — pleasant thermal signals show decreased activity in patients with MDD.”

To determine if whole-body hyperthermia has antidepressant effects, researchers conducted a 6-week randomized, double-blind study among 30 adults who met criteria for MDD, were free of psychotropic medication use and had 17-item Hamilton Depression Rating Scale scores of 16 or greater. Study participants were randomly assigned to a single session of whole-body hyperthermia or a sham condition matched to the primary intervention.

Immediately following intervention, 71.4% of participants who received the sham treatment believed they received whole-body hyperthermia, compared with 93.8% of participants who actually received whole-body hyperthermia.

Following the intervention, Hamilton Depression Rating Scale scores were significantly lower among the whole-body hyperthermia group vs. the sham group at week 1 (6.53; 95% CI, –9.9 to 3.16, P < .001), week 2 (6.35; 95% CI, 9.95 to 2.74, P = .001), week 4 (4.50; 95% CI, 8.17 to 0.84, P = .02) and week 6 (4.27; 95% CI, 7.94 to 0.61, P = .02).

These associations remained significant after accounting for potential moderating effects of between group-differences in baseline expectancy scores.

Overall, adverse events did not significantly differ between treatment groups. The most common adverse effects immediately following both interventions were headache, fatigue and dry mouth.

“Results from the current study suggest that [whole-body hyperthermia] holds promise as a safe, rapid-acting, antidepressant modality with a prolonged therapeutic benefit. Future studies will be required to identify both the optimal temperature and number and timing of treatments likely to produce the largest and longest lasting clinical response in most patients,” the researchers concluded. – by Amanda Oldt

Disclosure: Janssen reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.