Celecoxib may boost efficacy of anti-depressants in the treatment of bipolar disorder depression

By Liz Meszaros, MDLinx
Published November 11, 2016

Key Takeaways

Celecoxib—a COX-2 selective nonsteroidal anti-inflammatory drug indicated for the treatment of pain and inflammation in patients with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain, painful menstruation, and juvenile rheumatoid arthrisit—may help patients with bipolar disorder by boosting the efficacy of their antidepressant therapy, according to results from a study presented at the 5th International Congress on Psychiatry and Neurosciences, in Athens, Greece, in early October.    

“Such an intervention, if implemented relatively early in the course of the disease, may arrest the neuroprogressive course of bipolar disorder,” noted lead author Angelos Halaris, MD, PhD, professor, department of psychiatry and behavioral neurosciences, Loyola University Chicago Stritch School of Medicine, Chicago, IL.

For this study, Dr. Halaris and fellow researchers enrolled 55 adults diagnosed with bipolar disorder, aged 18 to 65 years, who were in the depressive phase of their disease and not benefitting from antidepressant therapy. Researchers randomized patients to either celecoxib plus the antidepressant escitalopram (n=31), or escitalopram plus placebo (n=24).

After 8 weeks, 78% of patients treated with celecoxib had a 50% or more reduction in depression scores, and 63% reported that their depression had ceased. In the placebo group, only 45% of patients had a 50% or more reduction in depression, and only 10% reported that their depression was gone.

In addition, the effects of the combined treatment with celecoxib were seen relatively early, within a week, much sooner than typical antidepressant therapy usually begins to take effect—at 4 to 6 weeks after treatment initiation.

Studies have previously found associations between depression and increased immune system activity and chronic inflammation, which affects—among other things—neurotransmitters. Perhaps by combating this inflammation, celecoxib increases the efficacy of antidepressants.

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