The role of anti-inflammatory treatment in psychiatric disorders

Anti-inflammatory treatment could be expected to show positive effects in the subgroup of psychiatric patients who show signs of inflammation, i.e. an increase in proinflammatory cytokines and PGE2. Cyclooxygenase-2 (COX-2) not only reduces the levels of proinflammatory cytokines, but also affects glutamatergic neurotransmission and tryptophan/kynurenine metabolism. In the meantime, several studies have been performed with the COX-2 inhibitor celecoxib in schizophrenia; the studies found a therapeutic effect, mainly in the early stages of the disorder. We were able to demonstrate a statistically significant therapeutic effect of celecoxib on depressive symptoms in a study in patients with major depression (MD). Another study in fifty patients with MD also showed a statistically significant better outcome with celecoxib. This paper will discuss immune-based therapeutic approaches in both schizophrenia and depression.