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Depression in Multiple Sclerosis: Epidemiology, Aetiology, Diagnosis and Treatment

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Abstract

Depressive disorders are common in patients with multiple sclerosis, influencing their quality of life and adherence to treatments, as well as becoming more frequent with the progression of the disease and in the secondary progressive form of multiple sclerosis. Patients with multiple sclerosis often experience a typical cluster of symptoms in association with depression, such as fatigue, pain and cognitive impairment. However, the pathogenesis of multiple sclerosis-related depression remains partially unclear, even though genetic, immune-inflammatory and psychosocial factors might be seen to play a role, in addition to the brain structural alterations documented by magnetic resonance imaging studies. The high incidence and burden of depression in people affected with multiple sclerosis are matters of crucial importance. Despite such importance, the efficacy of pharmacologic treatments has been poorly studied and, for the most part, the access to non-pharmacological treatments is partially dependent on the local health system availability. It has been determined that interferon-beta and glatiramer acetate do not cause depressive symptoms; however, no definitive data in this regard are avaible for the newer disease-modifyng medications. In this review, we discuss the diagnosis, prevalence, pathogenesis, clinical aspects, magnetic resonance imaging findings and treatments available in patients experiencing multiple sclerosis-related depression.

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Acknowledgements

The authors thank Bill McNeil and Michele Messmer-Uccelli for carefully reading the manuscript and Simona Minguzzi for her continuous support.

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  1. Department of Rehabilitation, C.R.R.F. “Mons. L. Novarese”, Trompone Street, Moncrivello, VC, Italy

    Claudio Solaro, Giulia Gamberini & Fabio Giuseppe Masuccio

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Correspondence to Claudio Solaro.

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Conflict of interest

Claudio Solaro served on the advisory boards of Biogen Idec and Merck Serono. He received speaking honoraria from Bayer Schering, Biogen Idec, Merck Serono, Almirall, Teva and Genzyme. He received research grants and support from the Italian MS Society Research Foundation (Fondazione Italiana Sclerosi Multipla). Giulia Gamberini and Fabio Giuseppe Masuccio have no conflicts of interest directly relevant to the content of this article.

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Solaro, C., Gamberini, G. & Masuccio, F.G. Depression in Multiple Sclerosis: Epidemiology, Aetiology, Diagnosis and Treatment. CNS Drugs 32, 117–133 (2018). https://doi.org/10.1007/s40263-018-0489-5

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