J Affect Disord. 2012 Apr 18;
Authors: Abbasi SH, Hosseini F, Modabbernia A, Ashrafi M, Akhondzadeh S
Abstract
BACKGROUND:
It has been proposed that the mechanism of the antidepressant effect of celecoxib is linked to its anti-inflammatory action and particularly its inhibitory effect on pro-inflammatory cytokines (e.g. interleukin-6(IL-6)). We measured changes in serum IL-6 concentrations and depressive symptoms following administration of celecoxib in patients with major depressive disorder (MDD).
METHODS:
In a randomized double-blind placebo-controlled study, 40 patients with MDD and Hamilton Depression Rating Scale-17 items (Ham-D) score ≥18 were randomly assigned to either celecoxib (200mg twice daily) or placebo in addition to sertraline (200mg/day) for 6 weeks. Outcome measures were serum IL-6 concentrations at baseline and week 6, and Ham-D scores at baseline and weeks 1, 2, 4, and 6.
RESULTS:
The celecoxib group showed significantly greater reduction in serum IL-6 concentrations (mean difference (95%CI)=0.42(0.30 to 0.55) pg/ml, t(35)=6.727, P<0.001) as well as Ham-D scores (mean difference (95%CI)=3.35(1.08 to 5.61), t(38)=2.99, P=0.005) than the placebo group.
The patients in the celecoxib group experienced more response (95%) and remission (35%) than the placebo group (50% and 5%, P=0.003 and 0.04 respectively).
Baseline serum IL-6 levels were significantly correlated with baseline Ham-D scores (r=0.378, P=0.016).
Significant correlation was observed between reduction of Ham-D scores and reduction of serum IL-6 levels at week 6 (r=0.673, P<0.001).
LIMITATIONS:
We did not measure other inflammatory biomarkers.
CONCLUSIONS:
We showed that the antidepressant activity of celecoxib might be linked to its capability of reducing IL-6 concentrations.
Moreover, supporting previous studies we showed that celecoxib is both safe and effective as an adjunctive antidepressant (Registration number: IRCT138903124090N1).
PMID: 22516310
Major Depressive Disorder is a pro-inflammatory condition. In general, the pro-inflammatory state results from a summation of multiple other health problems.
Interleukin-6 is often elevated in major depressive disorder. The problem in real-life is that the lab test for Interleukin-6 does not have high enough resolution as in research lab testing. This doesn’t make it practical to use regularly as a lab test.
Note that there was no mention about the results for Sertraline. Sertraline, in this case, was at a very high dose.
Notably, Celebrex did a better job than the average antidepressant in reducing severity of depression as measured by the HAM-D scale. A response rate of 95% is impressive when the average antidepressant response rate is 70%. Whether or not many patients were really in remission is a good question since many patients who have HAM-D scale scores of 0-7 0 which is often defined as being in depression yet still have significant pathology and would not refer themselves to have been in remission.
Again, given the very high response rate to Celebrex, I find it interesting that nothing was mentioned in the results about Sertraline (Zoloft). If Celebrex did a better job than Zoloft, then Celebrex should be considered a first-line antidepressant.