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

Abstract

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.

Shifting levels of peripheral inflammatory profiles as an indicator for comorbid multiple autoimmune diseases and bipolar disorder: a case report

“…Unfortunately, we did not test for other biomarkers including IL-1, soluble IL-2 receptor, and soluble TNF receptor type 1, which are of higher specificity for AID and BD. In recent years, new therapeutic agents targeting the immune system including non-steroidal anti-inflammatory drugs [ 24 , 25 ], N-acetylcysteine [ 26 ] GSK3 inhibitors [ 27 , 28 ], and glucocorticoids [ 29 , 30 ] have been trialed for BD treatment in pre- or clinical studies. In this case study, although methylprednisolone was used to control AID, its anti-inflammation effects might also play additional role in stabilizing the mood.…”