Neurology Central

The antidepressant activity of anticytokines: a novel therapeutic target?

A systematic review and meta-analysis performed by researchers led by Golam Khandaker (University of Cambridge, UK) has demonstrated that anti-inflammatory drugs could assist in the treatment of the symptoms of depression.

Previous work from the group indicated that elevated everyday levels of inflammatory markers in children were associated with an enhanced risk of depression and psychosis development in adulthood. These results highlighted a potential role of the immune system in mental illness.

In the current study, published recently in Molecular Psychiatry, the team analyzed the results of seven randomized controlled clinical trials involving the use of anti-cytokine drugs for the treatment of various autoimmune inflammatory diseases such as rheumatoid arthritis, psoriasis and Crohn’s disease, where depressive symptoms were measured as a secondary outcome.

A significant antidepressant effect associated with the use of these drugs was discovered, demonstrated through an alleviation of depressive symptoms, independent of improvements in physical illness. The findings indicate a potential contributory role for cytokines in depression and point to cytokine modulators as a novel treatment option for depression in chronically inflamed subjects.

While they have highlighted the potential use of these anticytokine drugs for depression, the group state that clinical trials with depression as the primary outcome are required in order to assess their effect in patients with inflammation who are free from other physical illnesses, as these could contribute to depression.

“The current approach of a ‘one-size-fits-all’ medicine to treat depression is problematic. All currently available antidepressants target a particular type of neurotransmitter, but a third of patients do not respond to these drugs. We are now entering the era of ‘personalized medicine’ where we can tailor treatments to individual patients. This approach is starting to show success in treating cancers, and it’s possible that in future we would use anti-inflammatory drugs in psychiatry for certain patients with depression,” concluded Khandaker.

Sources: Kappelmann N, Lewis G, Dantzer R, Jones PB, Khandaker GM. Antidepressant activity of anti-cytokine treatment: a systematic review and meta-analysis of clinical trials of chronic inflammatory conditions. Mol. Psychiatry. doi: 10.1038/mp.2016.167 (2016) [Epub ahead of print]; University of Cambridge press release