Celecoxib for Mood Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

The effects of celecoxib on a broad spectrum of mood disorders and on inflammatory parameters have not yet been comprehensively evaluated. The aim of this study was to systematically summarize the available knowledge on this topic. Data from both preclinical and clinical studies were analyzed, considering the efficacy and safety of celecoxib in the treatment of mood disorders, as well as the correlation of inflammatory parameters with the effect of celecoxib treatment. Forty-four studies were included. We found evidence supporting the antidepressant efficacy of celecoxib in a dose of 400 mg/day used for 6 weeks as an add-on treatment in major depression (SMD = −1.12 [95%Cl: −1.71,−0.52], p = 0.0002) and mania (SMD = −0.82 [95% CI:−1.62,−0.01], p = 0.05). The antidepressant efficacy of celecoxib in the above dosage used as sole treatment was also confirmed in depressed patients with somatic comorbidity (SMD = −1.35 [95% CI:−1.95,−0.75], p < 0.0001). We found no conclusive evidence for the effectiveness of celecoxib in bipolar depression. Celecoxib at a dose of 400 mg/d used for up to 12 weeks appeared to be a safe treatment in patients with mood disorders. Although an association between celecoxib response and inflammatory parameters has been found in preclinical studies, this has not been confirmed in clinical trials. Further studies are needed to evaluate the efficacy of celecoxib in bipolar depression, as well as long-term studies evaluating the safety and efficacy of celecoxib in recurrent mood disorders, studies involving treatment-resistant populations, and assessing the association of celecoxib treatment with inflammatory markers.

Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in ADHD: a systematic review and meta-analysis

“…To date, no study has been conducted to assess the efficacy of anti-inflammatory treatment in ADHD, with used e.g., non-steroidal anti-inflammatory drugs (NSAIDs). Clinical trials have confirmed the efficacy and safety of NSAIDs in other mental disorders in which inflammation plays a role in the pathogenesis, such as mood disorders ( 42 , 43 ). However, there are studies evaluating additional treatment of nutraceuticals with postulated anti-inflammatory properties in ADHD.…”

Role of Inflammatory Mechanisms in Major Depressive Disorder: From Etiology to Potential Pharmacological Targets

“…Of note, recent systematic reviews have also concluded that celecoxib may have a beneficial effect on MDD in humans [ 250 , 251 ]. A systematic review based on 44 studies found that a dose of 400 mg/day used for 6 weeks is effective as a complementary treatment for MDD [ 251 ].…”

“…Of note, recent systematic reviews have also concluded that celecoxib may have a beneficial effect on MDD in humans [ 250 , 251 ]. A systematic review based on 44 studies found that a dose of 400 mg/day used for 6 weeks is effective as a complementary treatment for MDD [ 251 ]. Although these results are promising, clinical studies have not yet been able to associate the antidepressant effects of celecoxib with the attenuation of inflammatory mediators.…”

“…Although these results are promising, clinical studies have not yet been able to associate the antidepressant effects of celecoxib with the attenuation of inflammatory mediators. Therefore, future studies are necessary, especially to assess possible long-term adverse effects [ 251 ].…”

Systemic Inflammatory Response Index (SIRI) at Baseline Predicts Clinical Response for a Subset of Treatment-Resistant Bipolar Depressed Patients

“…Due to its role in depressive neuroprogression generally, immune-metabolic dysregulation is also increasingly implicated in a subset of treatment-refractory forms of depressive illness [ 1 , 8 , 9 ]. In that vein, several randomized control trials (RCTs) have established preliminary support for adjunctive anti-inflammatory treatment in treatment-resistant depression [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. In a recent double-blind, placebo-controlled RCT in treatment-resistant bipolar depression (TRBDD), we demonstrated that clinical remission can be induced with adjunctive immune modulatory treatment with the selective cyclo-oxygenase 2 (COX2) inhibitor, celecoxib (CBX), in conjunction with an adequately dosed selective serotonin reuptake inhibitor (SSRI), escitalopram (ESC) [ 18 ].…”