Anti-inflammatory agents, such as aspirin, acetaminophen, statins and antibiotics, can safely and effectively limit the symptoms of major depression, launches a joint analysis of the available evidence, published online on 28 October 2019 in Journal of Neurology Neurosurgery & Psychiatry .
And the effects are even greater when these agents are added to standard antidepressant treatment, the results show.
About one-third of people who are clinically depressed do not respond well to current medications and talking therapies, and side effects are relatively common.
Evidence has emerged that inflammation contributes to the development of major depression, but the results of clinical trials using various anti-inflammatory agents to treat the condition have proved inconclusive.
Therefore, the researchers undertook to review the available evidence and to pool the data to see whether anti-inflammatory agents work better than dummy treatment (placebo) alone or when used as adjunctive therapy to standard antidepressant treatment.
Include anti-inflammatory drugs: non-steroidal anti-inflammatory drugs (NSAIDs); omega 3 fatty acids; drugs that limit the production of inflammatory chemicals (cytokine inhibitors); statins; steroids; antibiotics (minocycline); a medicine used to treat sleep disorders (modafinil); and N-acetyl cysteine, known as NAC, and used to loosen excess phlegm from cystic fibrosis and COPD and also taken as an antioxidant supplement.
Researchers examined the research databases to find suitable studies published by January 201
Collected data analysis suggested that anti-inflammatory agents were better than placebo and improved the effects of standard antidepressant treatment.
These agents are 52% more effective for reducing the severity of symptoms overall and 79% more effective for eliminating symptoms compared to placebo, as measured by an average depression depression score of 55.
A more detailed analysis showed that NSAIDs, omega-3 fatty acids, statins, and minocycline were most effective in reducing major depressive symptoms compared to placebo.
And the effects were even greater when one or the other of these agents was added to standard antidepressant treatment.
But anti-inflammatory drugs do not appear to improve the quality of life, although this may be due to the small number of studies examining this aspect, the researchers say.
No major side effects were apparent, although there were some gut ymptoms among those taking statins and NACs, and trials lasted only 4 to 12 weeks, so it was not possible to track the side effects in the longer term.
Researchers also indicate that not all studies track changes in depressive outcomes throughout the study period. The depression scales used in the studies differ, and those involving statins and minocycline include only a small number of patients.
However, they conclude: "The results of this systematic review suggest that anti-inflammatory agents play an antidepressant role in patients with major depressive disorders and are relatively safe. "
Reference:" The efficacy and safety of anti-inflammatory drugs for the treatment of major depressive disorder: a systematic review and meta-analysis of randomized controlled trials "by Shuang Bai, Wenliang Guo, Yangyang Feng, Hong Deng, Gaigai Li, Hao Nie, Guangyu Guo, Haihan Yu, Yang Ma, Jiahui Wang, Shiling Chen, Jie Jing, Jingfei Yang, Yingxin Tang, and Zhouping Tang, October 28, 2019, Journal of Neurology Neurosurgery & Psychiatry .
doi: 10.1136 / jnnp-2019-320912