[Αnti-Inflammatory medication as adjunctive antidepressive treatment]

Area of Science:

• Neuroscience
• Immunology
• Psychiatry

Background:

• Emerging evidence over 20 years suggests inflammation underlies depression pathophysiology.
• Clinical studies have explored anti-inflammatory drugs like NSAIDs and TNF-alpha inhibitors as adjuncts to conventional depression treatment.

Purpose of the Study:

• To review clinical trials investigating anti-inflammatory agents as adjunctive therapy for depressive disorder.
• To assess the efficacy and limitations of these immune-targeted treatments.

Main Methods:

• Analysis of seven clinical trials published between 2006 and 2013.
• Focus on four rigorously designed studies (randomized, double-blind, placebo-controlled).
• Examination of adjunctive treatments including Non-Steroid Anti-inflammatory Drugs (NSAIDs) and Tumor Necrosis Factor-alpha (TNFa) inhibitors.

Main Results:

• Promising results were observed across trials, with significant Hamilton score reductions in well-designed studies.
• Adjunctive anti-inflammatory therapy appears most beneficial for depressed patients with high baseline inflammatory markers.
• The TNF-alpha antagonist infliximab showed potential in recent trials.

Conclusions:

• Adjunctive anti-inflammatory medication shows potential for treating depression, especially in specific patient subgroups.
• Limitations include lack of guidelines, small sample sizes, and short follow-up periods.
• Future research should utilize biomarkers to personalize immune-targeted depression therapies and monitor treatment response.