Statin for mood and inflammation among adult patients with major depressive disorder: an updated meta-analysis

Abstract

IntroductionSeveral small sample-sized clinical trials have demonstrated a beneficial effect of statin on depressive mood among major depressive disorder (MDD) patients. However, observational studies have showed the increased risk of anxiety/depression with statin treatment. Therefore, we aimed to evaluate the effects of statin on depressive mood and inflammation status among MDD patients.MethodsWe performed an updated meta-analysis RCTs identified in systematic searches of PubMed, Cochrane library, Embase, ClinicalTrials.gov, CNKI, Wan fang, VIP, and SinoMed database (up to August 2023). The primary endpoint was the Hamilton depression rating scale (HDRS). The secondary endpoints were rate of response to treatment, remission rate, levels of C-reactive protein (CRP), cognition and blood lipid. We evaluated the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.ResultsThe search identified seven RCTs involving 448 patients with a median follow-up of 10.4 weeks (range, 6–12 weeks). Compared with selective serotonin reuptake inhibitors (SSRIs) alone, treatment with statin plus SSRIs was associated with a significantly decreased HDRS [mean difference (MD) = −2.79; 95% confidence interval (CI): −3.83 to −1.76] and C-reactive protein (MD = −0.42 mg/L; 95% CI: −0.53 to −0.12 mg/L), and decreased levels of lipid profiles (P < 0.05). Moreover, statin plus SSRIs was associated with a comparable rate of treatment response [relative risk (RR) = 1.26; 95% CI: 0.98 to 1.62], remission rate (RR = 1.33; 95% CI: 0.89 to 1.99). Meta-regression indicated that the follow-up period was a source of heterogeneity regarding the HDRS (r = 0.302, P = 0.041). The quality of evidence was rated as moderate for HDRS and response rate according to the GRADE.ConclusionStatin could safely and effectively improve the symptoms of depression and inflammation status among MDD patients.Systematic review registrationhttps://inplasy.com/inplasy-2022-3-0016/, identifier INPLASY2022230016.

Effect of a high dose atorvastatin as added-on therapy on symptoms and serum AMPK/NLRP3 inflammasome and IL-6/STAT3 axes in patients with major depressive disorder: randomized controlled clinical study

“…This strategy has been used with success across multiple diseases. Numerous studies support the idea that taking statins may have a favorable effect on mood, and several preclinical studies investigated the neuroprotective effect of statins on depressive behavior and reduced inflammation among MDD patients (Taniguti et al, 2019;Hai-Na et al, 2020;Massardo et al, 2022;Xiao et al, 2023). Haghighi et al investigated the role of atorvastatin in alleviating MDD symptoms, but they did not measure any serum biomarkers (Haghighi et al, 2014).…”

Are abnormalities in lipid metabolism, together with adverse childhood experiences, the silent causes of immune-linked neurotoxicity in major depression?

“…Thus, not only targeting the activated immune pathways but also reprogramming of lipid metabolism or blockade of cholesterol biosynthesis may be new drug targets to treat OMDD. There is existing evidence suggesting that statins may possess antidepressant properties, as indicated by studies conducted by [56][57][58]. However, it is recommended to complement such treatment with coenzyme Q10, as suggested by Maes et al [59].…”