A Randomized, Double-Blind Placebo-Controlled Trial on Effectiveness and Safety of Celecoxib Adjunctive Therapy in Adolescents with Acute Bipolar Mania

Mousavi, Seyed Yaser; Khezri, Rasoul; Karkhaneh-Yousefi, Mohammad-Ali; Mohammadinejad, Payam; Gholamian, Faezeh; Mohammadi, Mohammad Reza; Zeinoddini, Atefeh; Akhondzadeh, Shahin

doi:10.1089/cap.2016.0207

Cited by 59 publications

(27 citation statements)

References 40 publications

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“…2) full results could not be obtained despite efforts to contact the authors (Berk et al, 2012, Raghuvanshi et al, 2013, Halaris et al, 2014, Mousavi et al, 2017; 3) they reported results of a secondary analysis of a primary study ; 4) they did not have a placebo/TAU arm (Mohammadinejad et al, 2015). 14 studies were therefore included in the meta-analysis whilst the excluded studies were included in the qualitative analysis.…”

Section: Resultsmentioning

confidence: 99%

Anti-inflammatory treatments for mood disorders: Systematic review and meta-analysis

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Anti-inflammatory treatments for mood disorders: Systematic review and meta-analysis

et al. 2017

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“…A 2014 meta‐analysis suggests celecoxib, a selective COX‐2 inhibitor, is effective add‐on therapy in depression (Kohler et al, ). In the years since, celecoxib has shown promise as adjunctive therapy in young manic patients (Arabzadeh et al, ; Mousavi et al, ). Adjunctive celecoxib may also improve symptoms in schizophrenia according to a recent meta‐analysis (W. Zheng et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…In the years since, celecoxib has shown promise as adjunctive therapy in young manic patients (Arabzadeh et al, 2015;Mousavi et al, 2017).…”

Section: Cyclooxygenase-2 Inhibitorsmentioning

confidence: 99%

Putative neuroprotective pharmacotherapies to target the staged progression of mental illness

Robertson

Coronado

Sethi

et al. 2019

Early Intervention Psych

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Aim: Neuropsychiatric disorders including depression, bipolar and schizophrenia frequently exhibit a neuroprogressive course from prodrome to chronicity. There are a range of agents exhibiting capacity to attenuate biological mechanisms associated with neuroprogression. This review will update the evidence for putative neuroprotective agents including clinical efficacy, mechanisms of action and limitations in current assessment tools, and identify novel agents with neuroprotective potential.Method: Data for this review were sourced from online databases PUBMED, Embase and Web of Science. Only data published since 2012 were included in this review, no data were excluded based on language or publication origin.Results: Each of the agents reviewed inhibit one or multiple pathways of neuroprogression including: inflammatory gene expression and cytokine release, oxidative and nitrosative stress, mitochondrial dysfunction, neurotrophin dysregulation and apoptotic signalling. Some demonstrate clinical efficacy in preventing neural damage or loss, relapse or cognitive/functional decline. Agents include: the psychotropic medications lithium, second generation antipsychotics and antidepressants; other pharmacological agents such as minocycline, aspirin, cyclooxygenase-2 inhibitors, statins, ketamine and alpha-2-delta ligands; and others such as erythropoietin, oestrogen, leptin, N-acetylcysteine, curcumin, melatonin and ebselen.Conclusions: Signals of evidence of clinical neuroprotection are evident for a number of candidate agents. Adjunctive use of multiple agents may present a viable avenue to clinical realization of neuroprotection. Definitive prospective studies of neuroprotection with multimodal assessment tools are required.

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“…One RCT conducted among a sample of Iranian adolescents with acute mania (without psychotic features) studying the efficacy and safety of celecoxib as an adjuvant therapy showed a statistically significant reduction ( p = 0.04) in Young Mania Rating Scale scores in the intervention group compared with the placebo group at week 8 [43]. …”

Section: Celecoxib As An Adjuvant Treatment Option For Bpad: the Factsmentioning

confidence: 99%

“…However, these studies have limited external validity due to their narrow inclusion criteria. For instance, Mousavi et al [43] recruited only adolescents with acute mania, excluding those with psychosis, and Arabzadeh et al [42] only included manic patients without psychosis. There is a high frequency in the number of occurrences of auditory hallucination, paranoid delusions, and Schneider’s First Rank Symptoms in BPAD (18, 28, and 18%, respectively), with about half of the patients having grandiose delusions [46].…”

Section: Current Treatment Guidelines For Celecoxib In Bpads and Cavementioning

confidence: 99%

In the Realm of Psychoneuroimmunology: The Role of Celecoxib as an Add-On Treatment for Bipolar Mania

2018

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Bipolar affective disorder (BPAD) is a chronic debilitating psychiatric illness seriously affecting the quality of patients’ life. The available treatment is effective in about half of those suffering from the illness. The neurobiological basis of the disorder is not fully unraveled. With such lacunae, attempts have been made to decipher the underlying neuroimmunological process of the illness as is the case with other mental disorders. As a result, some inflammatory processes have been implicated in the etiology of BPAD, as described in this communication. Subsequently, the role of anti-inflammatory agents such as celecoxib was investigated by treating different phases of BPAD. Given the promising outcomes of several trials and reviews, celecoxib has gained momentum and has been recommended as an adjunctive treatment by some guidelines for treating resistant BPAD cases. This brief communication highlights some of the caveats in the randomized trials using celecoxib as an add-on treatment in bipolar mania specifically, which need to be addressed in future work.

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A Randomized, Double-Blind Placebo-Controlled Trial on Effectiveness and Safety of Celecoxib Adjunctive Therapy in Adolescents with Acute Bipolar Mania

Abstract: Celecoxib may be an effective adjuvant therapy in treatment of manic episodes (without psychotic features) of adolescents with bipolar mood disorder. The mood-stabilizing role of this drug might be mediated through its action on inflammatory cascades.

Cited by 59 publications

References 40 publications

Anti-inflammatory treatments for mood disorders: Systematic review and meta-analysis

Anti-inflammatory treatments for mood disorders: Systematic review and meta-analysis

Putative neuroprotective pharmacotherapies to target the staged progression of mental illness

In the Realm of Psychoneuroimmunology: The Role of Celecoxib as an Add-On Treatment for Bipolar Mania

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