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Effectiveness and tolerance of anti‐inflammatory drugs' add‐on therapy in major mental disorders: a systematic qualitative review
Author(s) -
Fond G.,
Hamdani N.,
Kapczinski F.,
Boukouaci W.,
Drancourt N.,
Dargel A.,
Oliveira J.,
Le Guen E.,
Marlinge E.,
Tamouza R.,
Leboyer M.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12211
Subject(s) - schizophrenia (object oriented programming) , major depressive disorder , bipolar disorder , minocycline , psychiatry , medicine , meta analysis , randomized controlled trial , polyunsaturated fatty acid , lithium (medication) , cognition , fatty acid , biology , biochemistry , microbiology and biotechnology , antibiotics
Objective To provide a systematic review of the literature regarding the efficacy of anti‐inflammatory drugs in three major mental disorders [major depressive disorder ( MDD ), schizophrenia and bipolar disorders]. Method Four databases were explored, without any year or language restrictions. The baseline search paradigm was limited to open‐labelled clinical and randomized controlled trials ( RCT s). Results Four major classes of anti‐inflammatory drugs were identified, namely polyunsaturated fatty acids ( PUFA s), cyclooxygenase ( COX ) inhibitors, anti‐ TNF alpha and minocycline. Effectiveness and benefit/risk ratio of each class in MDD , bipolar disorders and schizophrenia was detailed when data were available. Several meta‐analyses indicated effectiveness of PUFA s in MDD with a good tolerance profile. One meta‐analysis indicated that COX ‐2 specific inhibitors showed effectiveness in schizophrenia. Anti‐ TNF alpha showed important effectiveness in resistant MDD with blood inflammatory abnormalities. Minocycline showed effectiveness in schizophrenia. Conclusion Polyunsaturated fatty acids seem to have the best benefit/risk ratio profile but proved their effectiveness only in MDD . A number of anti‐inflammatory drugs are available as adjunct treatment for treatment‐resistant patients with MDD , schizophrenia and bipolar disorder. If used with caution regarding their possible side‐effects, they may be reasonable therapeutic alternatives for resistant symptomatology.