{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:32:32Z","timestamp":1786116752044,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Ministry of Science, Technology, Innovations and Communications of Brazil","doi-asserted-by":"publisher","award":["302574\/2021-2"],"award-info":[{"award-number":["302574\/2021-2"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Sertraline, a selective serotonin reuptake inhibitor widely prescribed for depressive disorders, has been proposed to exert immunomodulatory effects through modulation of inflammatory pathways; however, clinical evidence regarding its effects on circulating cytokines remains inconsistent. This systematic review and meta-analysis evaluated the effects of sertraline on inflammatory cytokines in adults. Methods: Searches were conducted in LILACS, CINAHL, MEDLINE\/PubMed, Cochrane Library, Scopus, and Web of Science to identify randomized single- or double-blind placebo-controlled trials assessing sertraline and inflammatory biomarkers. Ten studies met the eligibility criteria. Random-effects meta-analyses were performed for interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-\u03b1 (TNF-\u03b1). Results: Sertraline did not significantly reduce circulating IL-6 (MD \u22121.06, 95% CI \u22122.32 to 0.19; I2 = 86%; p = 0.10), IL-10 (MD &lt; 0.01, 95% CI \u22120.23 to 0.23; I2 = 72%; p = 0.98), or TNF-\u03b1 levels (MD \u22120.84, 95% CI \u22124.04 to 2.37; I2 = 72%; p = 0.61). Heterogeneity was substantial, all studies showed high overall risk of bias, and the certainty of evidence was very low for all outcomes. Conclusions: Current evidence does not support a significant or reliable anti-inflammatory effect of sertraline on circulating cytokines, and further well-designed trials using standardized inflammatory assessments are warranted.<\/jats:p>","DOI":"10.3390\/medsci14040460","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:43:02Z","timestamp":1786016582000},"page":"460","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sertraline as an Antidepressant and Inflammatory Cytokines in Depressive Disorders: A Systematic Review and Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials"],"prefix":"10.3390","volume":"14","author":[{"given":"Rafaela F.","family":"Rossetto","sequence":"first","affiliation":[{"name":"Systematic Reviews Center for Cardiovascular and Metabolic Health, School of Philosophy and Sciences, S\u00e3o Paulo State University (UNESP), Av. HyginoMuzzi Filho, 737, Mar\u00edlia 17525-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia S.","family":"Pissocaro","sequence":"additional","affiliation":[{"name":"Systematic Reviews Center for Cardiovascular and Metabolic Health, School of Philosophy and Sciences, S\u00e3o Paulo State University (UNESP), Av. HyginoMuzzi Filho, 737, Mar\u00edlia 17525-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2891-5600","authenticated-orcid":false,"given":"Davi A.","family":"Cavalheri","sequence":"additional","affiliation":[{"name":"Systematic Reviews Center for Cardiovascular and Metabolic Health, School of Philosophy and Sciences, S\u00e3o Paulo State University (UNESP), Av. HyginoMuzzi Filho, 737, Mar\u00edlia 17525-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-0728","authenticated-orcid":false,"given":"Rodrigo D.","family":"Raimundo","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Delineamento de Estudos e Escrita Cient\u00edfica, Centro Universit\u00e1rio, Faculdade de Medicina do ABC (FMABC), Santo Andr\u00e9 09060-870, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-876X","authenticated-orcid":false,"given":"Sandra Maria","family":"Barbalho","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Mar\u00edlia (UNIMAR), Mar\u00edlia 17525-902, SP, Brazil"},{"name":"Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Mar\u00edlia (UNIMAR), Mar\u00edlia 17525-902, SP, Brazil"},{"name":"Department of Biochemistry and Nutrition, School of Food and Technology of Mar\u00edlia (FATEC), Mar\u00edlia 17500-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-5285","authenticated-orcid":false,"given":"Andrey A.","family":"Porto","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Medicine of Ribeirao Preto, Faculdade de Medicina de Ribeir\u00e3o Preto\/Universidade de S\u00e3o Paulo\u2014FMRP\/USP, Ribeirao Preto 14049-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8114-9055","authenticated-orcid":false,"given":"David M.","family":"Garner","sequence":"additional","affiliation":[{"name":"Cardiorespiratory Research Group, School of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford OX3 0BP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7477-3805","authenticated-orcid":false,"given":"Vitor E.","family":"Valenti","sequence":"additional","affiliation":[{"name":"Systematic Reviews Center for Cardiovascular and Metabolic Health, School of Philosophy and Sciences, S\u00e3o Paulo State University (UNESP), Av. HyginoMuzzi Filho, 737, Mar\u00edlia 17525-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"GBD 2019 Mental Disorders Collaborators (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry, 9, 137\u2013150.","DOI":"10.1016\/S2215-0366(21)00395-3"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41572-020-0200-2","article-title":"Comorbid depression in medical diseases","volume":"6","author":"Gold","year":"2020","journal-title":"Nat. Rev. Dis. 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