05. Has the Time Come to Treat Depression With Anti-inflammatory Medication?

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For our next Quick Take, let’s look at an important question about the treatment of depression. You’ve been hearing more and more about inflammation in regard to depression as a potential mechanism, and that peripheral inflammation, like GI tract, gut inflammation, can somehow through its inflammatory factors, like interleukin-1 and interleukin-6, make its way to the brain and have an impact on mood. If that’s true, that somehow peripheral inflammation is having a brain impact, it begs the question, could an anti-inflammatory agent help treat depression? Specifically, should we think about routinely prescribing an anti-inflammatory, like a nonsteroidal anti-inflammatory, along with our antidepressants?

To address this question, now comes a rigorous meta-analysis looking at 36 randomized trials with a net of 6000 subjects, where patients received both an antidepressant agent and an anti-inflammatory. These included nonsteroidal anti-inflammatories—although, unfortunately, in all but 1 study, that was celecoxib. So, medications like ibuprofen