Efficacy of adjunctive celecoxib treatment for patients with major depressive disorder: A meta-analysis

Na, Kyoung-Sae; Lee, Kang Joon; Lee, Ji Sung; Cho, Young Sung; Jung, Han‐Yong

doi:10.1016/j.pnpbp.2013.09.006

Cited by 157 publications

(95 citation statements)

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“…A similar result was obtained with a celecoxib add-on approach to sertraline in MD (Abbasi et al 2012 ). A metaanalysis on the use of COX-2 inhibitors in MD found an overall benefi t of celecoxib add-on therapy (Na et al 2013 ).…”

Section: Celecoxib As Adjunctive Therapy In Major Depressionsupporting

confidence: 59%

Immunomodulation as Therapeutic Approach in Schizophrenia and Depression: State of the Art

Müller

2015

Current Topics in Neurotoxicity

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Infl ammation has been discussed for decades as an underlying cause of psychiatric disorders such as major depression (MD) and schizophrenia. Almost a hundred years ago, an anti-infl ammatory therapeutic approach, so-called vaccination therapy, was proposed by Wagner von Jauregg. In schizophrenia and MD, opposite patterns of the type-1 and type-2 immune response seem to be associated with differences in the activation of the enzyme indoleamine 2,3-dioxygenase (IDO) and in tryptophan-kynurenine metabolism. These differences are associated with an imbalance in glutamatergic neurotransmission, which may contribute to an excess of N -methyl-D -aspartate (NMDA) agonism in depression and NMDA antagonism in schizophrenia. In both schizophrenia and depression the immunological imbalance results in increased prostaglandin E 2 (PE 2 ) production and probably also in increased cyclooxygenase-2 (COX-2) expression. Although there is strong evidence for the view that the interactions of the immune system, IDO, serotonergic system and glutamatergic neurotransmission play a key role in schizophrenia and depression, several gaps remain that need to be closed by intense research. Accordingly, anti-infl ammatory or immune-modulating substances might have benefi cial effects in schizophrenia and MD. COX-2 inhibitors have shown encouraging results in animal models. Moreover, during the last decade many clinical studies have been performed with COX-2 inhibitors, mostly celecoxib, in schizophrenia and MD. For ethical reasons, all these studies used an add-on design, i.e. the COX-2 inhibitor was given adjunctive to either antipsychotics (in schizophrenia) or antidepressants (in MD). Although an add-on design is a methodological challenge, favourable effects of COX-2 inhibitors were observed in placebo-controlled double-blind studies in both indications. Meta-analytic studies proved a signifi cant therapeutic effect of COX-2 inhibitors in MD and in early stages of schizophrenia. Other pharmacological approaches based on N. Müller (*) Department of Psychiatry and Psychotherapy , Ludwig-Maximilians University Munich , Nussbaumstr. 7 , 80336 Munich , Germany e-mail: Norbert.Mueller@med.uni-muenchen.de 352 immunological effects are discussed. Anti-infl ammatory and immune-modulating compounds are promising but still need careful further scientifi c evaluation, including clinical studies in larger samples of patients.

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Section: Celecoxib As Adjunctive Therapy In Major Depressionsupporting

confidence: 59%

Immunomodulation as Therapeutic Approach in Schizophrenia and Depression: State of the Art

Müller

2015

Current Topics in Neurotoxicity

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“…In a metaanalysis (4 studies, N ¼ 150) of adjunctive celecoxib, higher response and remission rates and lower dropout rates were reported with the NSAID compared to placebo. 145 In contrast, a subsequent small trial (N ¼ 30 female patients with first episode of MDD) did not demonstrate efficacy of adjunctive celecoxib with sertraline. 146 Preliminary studies of pramipexole, a dopaminergic D2, D3, and D4 receptor agonist that has evidence for efficacy in bipolar depression, 147 found some benefit in TRD.…”

Section: What Novel Treatments Are Being Investigated?mentioning

confidence: 94%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

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Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. ''Pharmacological Treatments'' is the third of six sections of the 2016 guidelines. With little new information on older medications, treatment recommendations focus on second-generation antidepressants.Results: Evidence-informed responses are given for 21 questions under 4 broad categories: 1) principles of pharmacological management, including individualized assessment of patient and medication factors for antidepressant selection, regular and

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“…Studies using postmortem brain samples showed elevated gene expression of proinflammatory cytokines in the frontal cortex of people with a history of depression (14,15). Taking these data together, we find that it is likely that both peripheral and central inflammations are associated with depression and that antiinflammatory drugs, such as cyclooxygenase inhibitors, could ameliorate depressive symptoms in depressed patients (16,17).…”

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confidence: 68%

Gene deficiency and pharmacological inhibition of soluble epoxide hydrolase confers resilience to repeated social defeat stress

Ren

Ishima

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

134

156

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Depression is a severe and chronic psychiatric disease, affecting 350 million subjects worldwide. Although multiple antidepressants have been used in the treatment of depressive symptoms, their beneficial effects are limited. The soluble epoxide hydrolase (sEH) plays a key role in the inflammation that is involved in depression. Thus, we examined here the role of sEH in depression. In both inflammation and social defeat stress models of depression, a potent sEH inhibitor, TPPU, displayed rapid antidepressant effects. Expression of sEH protein in the brain from chronically stressed (susceptible) mice was higher than of control mice. Furthermore, expression of sEH protein in postmortem brain samples of patients with psychiatric diseases, including depression, bipolar disorder, and schizophrenia, was higher than controls. This finding suggests that increased sEH levels might be involved in the pathogenesis of certain psychiatric diseases. In support of this hypothesis, pretreatment with TPPU prevented the onset of depression-like behaviors after inflammation or repeated social defeat stress. Moreover, sEH KO mice did not show depressionlike behavior after repeated social defeat stress, suggesting stress resilience. The sEH KO mice showed increased brain-derived neurotrophic factor (BDNF) and phosphorylation of its receptor TrkB in the prefrontal cortex, hippocampus, but not nucleus accumbens, suggesting that increased BDNF-TrkB signaling in the prefrontal cortex and hippocampus confer stress resilience. All of these findings suggest that sEH plays a key role in the pathophysiology of depression, and that epoxy fatty acids, their mimics, as well as sEH inhibitors could be potential therapeutic or prophylactic drugs for depression.brain-derived neurotrophic factor | depression | epoxyeicosatrienoic acid | soluble epoxide hydrolase | resilience

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Efficacy of adjunctive celecoxib treatment for patients with major depressive disorder: A meta-analysis

Cited by 157 publications

References 50 publications

Immunomodulation as Therapeutic Approach in Schizophrenia and Depression: State of the Art

Immunomodulation as Therapeutic Approach in Schizophrenia and Depression: State of the Art

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

Gene deficiency and pharmacological inhibition of soluble epoxide hydrolase confers resilience to repeated social defeat stress

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