There is a high co-morbidity between chronic inflammatory disorders and depression1. Proinflammatory cytokines like TNFα seems to play a central role in the pathogenesis of these disorders and its neutralization provides a potent treatment for inflammatory disorders2. Trying et al (2006) showed that a TNF-α blocker -etanercept- caused at least a 50% improvement in depression scores in psoriasis patients.3 These observations together with the theoretical background led to the hypothesis that TNF-α blockers may reverse depressive symptoms associated with chronic inflammatory disorders.

To evaluate the effectiveness of TNF-α blockers on symptoms of ankylosing spondylitis (AS) and depression.

9 treatment resistant AS patients with no contraindications for TNFα blockers, who were not using any psychotropic or nonbiological drugs were enrolled for the study. TNF-α blockers were given at weeks 0, 2 and 6 and Hamilton Depression and Anxiety Scales (HAMD, HAMA), Hospital Depression and Anxiety Questionnaire (HAD), Quality of Life Scale (SF36), AS severity index (BASDAI) was applied to the patients at week 0, 2 and 6.

There was a significant reduction in HAMD (p = 0.00), HAMA (p = 0.00), HAD-anxiety scores (p = .004) and a significant improvement in SF36- physical role (p = 0.00), physical role limitations (p = 0.01), bodily pain (p = 0.01), general health perception (p = 0.00), vitality (p = 0.02) and emotional role limitations (p = 0.01) subscales and BASDAI scores (p = 0.00) from week 0 to weeks 2 and 6.

This study showed that TNFα blockers may have a potential antidepressant effect besides its antiinflammatory effect in AS patients in a small sample.