Beneficial Antidepressant Effect of Aceclofenac Add-on Therapy to Sertraline for Treatment of Depression

Abstract

Numerous clinical studies reported effectiveness of add-on non-steroidal anti-inflammatory agents in patients with depression. In the present study, we investigated efficacy and safety of add-on aceclofenac alone or in-combination with serratiopeptidase to sertraline in patients with depression. A total of 102 patients with depression were assigned to three different treatment groups: A) add-on aceclofenac monotherapy (200mg/day) to sertraline B) add-on fixeddose combination (FDC) of aceclofenac and serratiopeptidase (200+30mg/ day) to sertraline C) sertraline (150mg/day). Efficacy measures included the HAM-D17 score, MADRS score and biomarkers levels like interleukin-6, cortisol and brain-derived neurotrophic factor (BDNF). Treatment with addon aceclofenac monotherapy or its combination with serratiopeptidase to sertraline showed significant reduction in HAM-D17 score at week 8 and week 12 as compared to sertraline monotherapy. Add-on therapies also showed reduction in MADRS score at week 12. Interleukin-6 levels significantly reduced in patients treated with add-on aceclofenac monotherapy or add-on FDC treatment with that of sertraline monotherapy at week 12. Both add-on treatments to sertraline also showed significant improvement in BDNF levels as compared to sertraline monotherapy at week 12.The antidepressant activity and neuroprotective potential of add-on aceclofenac monotherapy or its combination with serratiopeptidase to sertraline can be attributed to its capability of reducing IL-6 and cortisol levels and augmenting levels of BDNF.