The presence of peripheral inflammatory markers in patients with major depressive disorder, the associated symptoms profiles and the antidepressant efficacy of celecoxib

Abstract

Despite the treatability and advances in treatment of major depressive disorder (MDD), treatment responsiveness is still only around 30-50%. The involvement of pro-inflammatory factors in the pathogenesis of major depression is one of the new perspectives of current research. This is a prospective study over an 8-week period in 50 MDD patients with single or multiple episodes recruited from the Timișoara Psychiatry Clinic during 2016-2019. Several psychometric measures were applied and baseline for C Reactive Protein (CRP) and Interleukin-6 (IL-6) blood levels were determined. Among the 17-item Hamilton Depression Rating Scale (HAM-D), somatic anxiety, somatic symptoms-general and insight had significantly higher scores in MDD patients with elevated inflammatory markers compared to their counterpart with normal inflammatory marker levels (p < 0.05). Add-on celecoxib treatment determined a significantly lowered mean HAM-D scores at endpoint in MDD patients with elevated inflammatory markers (p < 0.01). Linear regression analysis revealed the presence of inflammation (IL-6 and/or CRP) and add-on celecoxib treatment as significantly influencing endpoint HAM-D scores (p < 0.01). Routine determination of inflammatory markers in MDD patients, together with add-on celecoxib treatment, generates new opportunities for the clinical management of this highly frequent psychiatric condition in the general population.