There has long been interest in inflammation as a mediator for affective disorders. A systematic review and meta-analysis of randomised controlled trials (RCTs) has recently assessed the efficacy and safety of anti-inflammatory agents used in treating major depressive disorders. Data from 30 RCTs with 1,610 participants suggested a reduction in depressive symptoms (standard mean difference −0.55, 95% CI −0.75 to −0.35, I2=71%) and increased responses (risk ratio [RR] 1.52, 95% CI 1.30 to 1.79, I2=29%) and remission rates (RR 1.79, 95% CI 1.29 to 2.49, I2=41%) in patients taking anti-inflammatory agents compared to the placebo. Following subgroup meta-analysis, patients undergoing monotherapy or adjunctive treatment both exhibited large reduction in symptom severity, while significant antidepressant outcomes were associated with the use of non-steroidal anti-inflammatory agents, omega-3 fatty acids, statins and minocyclines. In addition, subgroup analysis investigated differences in gender, quality of life, adverse events, sponsor type and study quality, with the only significant difference between groups being the occurrence of gastrointestinal events. The researchers have asserted that anti-inflammatory agents were effective and relatively safe in treating patients with major depressive disorders, suggesting a new pathway to explore, especially for those with treatment resistant depression. The full review, published in the BMJ, can be accessed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh