A new study* published in the Journal of Neurology, Neurosurgery, and Psychiatry asserts the efficacy of anti-inflammatories in treating major depression. This adds to the mounting evidence that there is a connection between emotional functioning and inflammation.
An increasing number of studies have shown that depression and/or bipolar disorder are accompanied by immune system dysregulation, inflammation, and high levels of cytokines. Researchers have found that inflammation triggers depression, almost like an allergic reaction.
Inflammation is a defense mechanism triggered in the body when it reacts to an attack and gathers special resources in response. It’s a requirement for survival. For example, the red soreness that appears around an infected wound is an inflammatory response essential to isolating invaders and destroying them before they spread. The body responds with inflammation to a wide variety of threats, including not only infections but also irritants, stress, and physical trauma.
When we are exposed to any of these triggers, the body produces small protein cells called cytokines. These small cells facilitate the response of the body to the threat. Their presence can be measured to assess inflammation levels in the body. (Chang et al., 2010).
Growing evidence on many fronts demonstrates that inflammation affects how we feel. This influence is exerted through many systems, including the immune system, metabolism, sleep, stress responses, cognitive thinking, memory, expression, impulse control, mood, clarity, and more.
About 6% of adults in the world are affected by major depressive disorder (MDD) (Bai et al., 2019) so this most recent study has potential implications for a large number of people and their treatment providers.
In a meta-analysis of 30 randomized control trials (RCT) with 1610 participants, the authors examined the efficacy and safety of anti-inflammatory agents as either standalone or adjunct treatment of individuals with major depression. Anti-inflammatory treatments were defined as NSAIDs, omega-3 fatty acids (omega-3 FA), cytokine inhibitors, statins, corticosteroids, minocycline, pioglitazone, modafinil and N-acetylcysteine (NAC).
While the authors reported several methodological limitations, their systematic meta-analysis suggested that anti-inflammatory agents can safely and effectively reduce symptoms of major depression. A sub-analysis found that anti-inflammatories as adjunctive treatment with antidepressants with NSAIDs, omega-3 FAs, statins, and minocycline showed significant antidepressant effects for major depression.
These findings contribute to an expanding body of evidence important for mental health practitioners, educators, and patients. There’s a growing call to address bio-medical root causes of inflammation and how they link to mental health symptoms.
*This study report is not a substitute or recommendation for the use of anti-inflammatories without consulting a medical professional.
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Chang, T. T., Yen, Y-C., (2010). Cytokines and Major Psychiatric Disorders. Taiwanese Journal of Psychiatry (Taipei) Vol. 24 No. 4, 257-268.
Bai S, Guo W, Feng Y, et al. Efficacy and safety of anti-inflammatory agents for the treatment of major depressive disorder: a systematic review and meta-analysis of randomised controlled trialsJournal of Neurology, Neurosurgery & Psychiatry Published Online First: 28 October 2019. doi: 10.1136/jnnp-2019-320912