Anti-Inflammatories Help Major Depression

Authored by psychologytoday.com and submitted by mvea

Source: Odelya Gertel Kraybill Expressive Trauma Integration

A new study* published in the Journal of Neurology Neurosurgery and asserts the efficacy of anti-inflammatories in treating major . This adds to the mounting evidence that there is a connection between emotional functioning and inflammation.

An increasing number of studies have shown that depression and/or bipolar disorder are accompanied by immune system dysregulation, inflammation, and high levels of cytokines. Researchers have found that inflammation triggers depression, almost like an allergic reaction.

Inflammation is a defense mechanism triggered in the body when it reacts to an attack and gathers special resources in response. It’s a requirement for survival. For example, the red soreness that appears around an infected wound is an inflammatory response essential to isolating invaders and destroying them before they spread. The body responds with inflammation to a wide variety of threats, including not only infections but also irritants, , and physical .

When we are exposed to any of these triggers, the body produces small protein cells called cytokines. These small cells facilitate the response of the body to the threat. Their presence can be measured to assess inflammation levels in the body. (Chang et al., 2010).

Growing evidence on many fronts demonstrates that inflammation affects how we feel. This influence is exerted through many systems, including the immune system, metabolism, sleep, stress responses, cognitive thinking, , expression, , mood, clarity, and more.

About 6% of adults in the world are affected by major depressive disorder (MDD) (Bai et al., 2019) so this most recent study has potential implications for a large number of people and their treatment providers.

In a meta-analysis of 30 randomized control trials (RCT) with 1610 participants, the authors examined the efficacy and safety of anti-inflammatory agents as either standalone or adjunct treatment of individuals with major depression. Anti-inflammatory treatments were defined as NSAIDs, fatty acids (omega-3 FA), cytokine inhibitors, statins, corticosteroids, minocycline, pioglitazone, and N-acetylcysteine (NAC).

While the authors reported several methodological limitations, their systematic meta-analysis suggested that anti-inflammatory agents can safely and effectively reduce symptoms of major depression. A sub-analysis found that anti-inflammatories as adjunctive treatment with with NSAIDs, omega-3 FAs, statins, and minocycline showed significant antidepressant effects for major depression.

These findings contribute to an expanding body of evidence important for mental health practitioners, educators, and patients. There’s a growing call to address bio-medical root causes of inflammation and how they link to mental health symptoms.

*This study report is not a substitute or recommendation for the use of anti-inflammatories without consulting a medical professional.

vianiznice on November 12nd, 2019 at 12:46 UTC »

Considering depression can cause inflammation, I wouldn't be surprised if it works the other way round too.

Orangutan on November 12nd, 2019 at 12:44 UTC »

What causes inflammation and how do you test it?

mvea on November 12nd, 2019 at 10:33 UTC »

The title of the post is a copy and paste from the subtitle and first two paragraphs of the linked academic press release here:

New study suggests that anti-inflammatories can mitigate MDD symptoms

This adds to the mounting evidence that there is a connection between emotional functioning and inflammation.

Researchers have found that inflammation triggers depression, almost like an allergic reaction.

Journal Reference:

Bai S, Guo W, Feng Y, et al

Efficacy and safety of anti-inflammatory agents for the treatment of major depressive disorder: a systematic review and meta-analysis of randomised controlled trials

Journal of Neurology, Neurosurgery & Psychiatry

Published Online First: 28 October 2019.

Link: https://jnnp.bmj.com/content/early/2019/08/29/jnnp-2019-320912

doi: 10.1136/jnnp-2019-320912

Abstract

Objectives To systematically review the efficacy and safety of anti-inflammatory agents for patients with major depressive disorders.

Methods We searched the literature to identify potentially relevant randomised controlled trials (RCTs) up to 1 January 2019. The primary outcome was efficacy, measured by mean changes in depression score from baseline to endpoint. Secondary outcomes included response and remission rates and quality of life (QoL). Safety was evaluated by incidence of classified adverse events. Heterogeneity was examined using the I2 and Q statistic. Pooled standard mean differences (SMDs) and risk ratios (RRs) were calculated. Subgroup meta-analyses were conducted based on type of treatment, type of anti-inflammatory agents, sex, sponsor type and quality of studies.

Results Thirty RCTs with 1610 participants were included in the quantitative analysis. The overall analysis pooling from 26 of the RCTs suggested that anti-inflammatory agents reduced depressive symptoms (SMD −0.55, 95% CI −0.75 to −0.35, I2=71%) compared with placebo. Higher response (RR 1.52, 95% CI 1.30 to 1.79, I2=29%) and remission rates (RR 1.79, 95% CI 1.29 to 2.49, I2=41%) were seen in the group receiving anti-inflammatory agents than in those receiving placebo. Subgroup analysis showed a greater reduction in symptom severity in both the monotherapy and adjunctive treatment groups. Subgroup analysis of non-steroidal anti-inflammatory drugs, omega-3 fatty acids, statins and minocyclines, respectively, disclosed significant antidepressant effects for major depressive disorder (MDD). For women-only trials, no difference in changes of depression severity was found between groups. Subanalysis stratified by sponsor type and study quality led to the same outcomes in favour of anti-inflammatory agents in both subgroups. Changes of QoL showed no difference between the groups. Gastrointestinal events were the only significant differences between groups in the treatment periods.

Conclusions Results of this systematic review suggest that anti-inflammatory agents play an antidepressant role in patients with MDD and are reasonably safe.