Could peripheral 5-HT level be used as a biomarker for depression diagnosis and treatment? A narrative minireview

The serotonin hypothesis of depression is still influential, but the relationship between peripheral 5-HT levels and depression is still unknown. This review aimed to verify whether peripheral 5-HT levels could be used as a biomarker for depression diagnosis and treatment. PubMed and EMBASE were searched using terms appropriate to the area of research. Articles from 1957 to 2022 in the following terms were identified: depression, 5-HT, serotonin and peripheral (serum, plasma, blood platelets). 33 studies were included: seven clinical trials about periphery 5-HT levels in depressive patients compared to normal subjects, 15 clinical trials about changes of peripheral 5-HT levels in patients with depression after drug treatment and 11 animal experiments about peripheral 5-HT levels in animal models of depression. Peripheral 5-HT levels presented three different outcomes before and after antidepressant treatments: increased, decreased and no significant change. In conclusion, changes in peripheral 5-HT levels did not show consistent results among these studies. Peripheral 5-HT level could not be used as a biomarker both for depression diagnosis and for antidepressant efficacy evaluation.