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Table 3 Selected studies assessing the efficacy of antiinflammatory agents among patients with unipolar and bipolar depression, schizophrenia, and obsessive-compulsive disorder

From: Neuroinflammation and psychiatric illness

Study

Study design

Group comparison

Number of subjects

Functional outcome

COX-2 inhibitors

    

  Müller et al. 2006 [238]

RCT

Celecoxib (200 mg bid) + reboxetine versus placebo + reboxetine

40 MDD (acute)

Significantly greater decrease in depressive symptoms in the treatment group (P = 0.035)

  Akhondzadeh et al. 2009 [239]

RCT

Celecoxib (200 mg bid) + fluoxetine versus placebo + fluoxetine

40 MDD

Significant improvement of depressive symptoms (P <0.001), and a greater percentage of responders (90% versus 50%, P = 0.01) and remission (35% versus 5%, P = 0.04) in the treatment group

  Medlewicz et al. 2006 [240]

Open-label

Acetylsalicylic acid (160 mg qd) + SRI

24 MDD and BPD

52.4% responder rate, significant improvement within one week (P <0.0001) following treatment; sustained at four weeks

  ClinicalTrials.gov http://www.clinicaltrials.gov/NCT00510822 completed, pending results

RCT

Cimicoxib (50 mg bid) + sertraline versus placebo + sertraline

169 MDD

Primary outcome measure is mean change in Hamilton Depression Rating Scale from baselineto six-week endpoint

  Nery et al. 2008 [263]

RCT

Celecoxib versus placebo

28 BPD (depressive and mixed states)

No significant differences in depressive or manic symptoms.

  Müller et al. 2002 [242]

RCT

Celecoxib (400 mg qd) + risperidone versus placebo + risperidone

50 (acute schizophrenia)

Significant improvement of positive and negative symptoms (P = 0.05), as well as cognition (P <0.06) in treatment group at five weeks

  Müller et al. 2010 [244]

RCT

Celecoxib + amisulpride versus placebo + amisulpride

49 schizophrenia (first-episode)

Significant improvement of positive and negative symptoms in celecoxib plus amisulpride group relative to amisulpride alone (P <0.001) at six-weeks

  Sayyah et al. 2011 [245]

RCT

Celecoxib (200 mg bid) + fluoxetine versus placebo + fluoxetine

50 OCD

Significantly greater reduction in YBOCS scores in the celecoxib treatment group at two weeks (P = 0.007) and at the eight week end-point (P = 0.037)

Minocycline

    

  Levine et al. 1996 [264]

Case report

Minocycline (150 mg qd) started 20 years after disease onset

1 BPD

Marked decrease in depressive symptoms (HAM-D score went from 25 to 8) within one week following treatment, sustained at two weeks.

  Levkovitz et al. 2009 [265]

RCT

Minocycline (200 mg qd) versus placebo

21 schizophrenia (early and acute-phase)

Significant improvement of negative symptoms and cognitive dysfunction in treatment group (P <0.01)

  ClinicalTrials.gov NCT01433055 recruiting, estimated completion 7/15

RCT

Minocycline (100 mg bid) + clozapine versus placebo + clozapine

60 schizophrenia (refractory to ≥2 antipsychotics)

Primary outcome is the improvement in positive symptoms as measured by the four-item sub-factor of the Brief Psychiatric Rating Scale.

  Miyaoka et al. 2007 [266]

Case series

Minocycline (150 mg qd) + stable antipsychotic regiment

2 schizophrenia

Complete resolution of positive and negative symptoms with minocycline, sustained for one to two years. Symptom exacerbation occurred one-week following minocycline discontinuation (in both cases). In one patient, the complete resolution of symptoms occurred at age 61, which was 41 years after disease onset.

  Miyaoka et al. 2008 [267]

Open-label

Minocycline (150 mg tid)

22 schizophrenia

Significant improvement of positive and negative symptoms at four to eight weeks (P = 0.0001)

  Rodriguez et al. 2010 [268]

Open-label

Minocycline (100 mg bid)

9 OCD

22% had a 40% to 46% YBOCS reduction at 12 weeks; the group as a whole did not have a significant change in YBOCS score.

  1. ASA, acetylsalicylic acid; BPD, bipolar disorder; COX-2, cycloxygenase-2; HAM-D: Hamilton Depression Rating Scale; MDD, major depressive disorder; OCD, obsessive-compulsive disorder; SRI, serotonin reuptake inhibitor; RCT, randomized controlled trial; YBOCS: Yale-Brown Obsessive-Compulsive Scale.