In a randomized, double-blind clinical trial, adjuvant atorvastatin improved symptoms of depression and blood lipid values in patients suffering from severe major depressive disorder

Haghighi, Mohammad; Khodakarami, Saeed; Jahangard, Leila; Ahmadpanah, Mohammad; Bajoghli, Hafez; Holsboer‐Trachsler, Edith; Brand, Serge

doi:10.1016/j.jpsychires.2014.07.018

Cited by 63 publications

(68 citation statements)

References 30 publications

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“…). We identified 39 studies covering 44 RCTs with a total of 10 891 individuals: 14 trials ( N = 4451) studied NSAIDs [five add‐ons , eight monotherapy except one trial where 45% of patients were on antidepressant medication ], 12 ( N = 3868) studied cytokine inhibitors [all as monotherapy except for one study where 62% of the patients were treated with antidepressants ], 9 ( N = 2118) studied statins [three add‐ons and six monotherapy ], 3 ( N = 119) studied pioglitazone as add‐on , 3 ( N = 162) studied minocycline [two add‐ons and one monotherapy ], and 3 ( N = 173) studied glucocorticoids as monotherapy . Of these, eight RCTs could not be included since we did not have access to the necessary data, neither published or after contact to the authors.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of anti‐inflammatory treatment on major depressive disorder or depressive symptoms: meta‐analysis of clinical trials

Köhler‐Forsberg

Lydholm

Hjorthøj

et al. 2019

Acta Psychiatr Scand

296

207

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Efficacy of anti-inflammatory treatment on major depressive disorder or depressive symptoms: meta-analysis of clinical trials K€ ohler-Forsberg O, Nicolaisen Lydholm C, Hjorthøj C, Nordentoft C, Mors O, Benros ME. Efficacy of anti-inflammatory treatment on major depressive disorder or depressive symptoms: meta-analysis of clinical trials Background: No study has gathered evidence from all randomized clinical trials (RCTs) with anti-inflammatory drugs measuring antidepressant effects including a detailed assessment of side-effects and bias. Methods: We performed a systematic review identifying RCTs published prior to January 1, 2018, studying antidepressant treatment effects and sideeffects of pharmacological anti-inflammatory intervention in adults with major depressive disorder (MDD) or depressive symptoms. Outcomes were depression scores after treatment, remission, response, and side-effects. Pooled standard mean differences (SMD) and risk ratios (RR) including 95% confidence intervals (95%-CI) were calculated. Results: We identified 36 RCTs, whereof 13 investigated NSAIDs (N = 4214), 9 cytokine inhibitors (N = 3345), seven statins (N = 1576), 3 minocycline (N = 151), 2 pioglitazone (N = 77), and 2 glucocorticoids (N = 59). Anti-inflammatory agents improved depressive symptoms compared to placebo as add-on in patients with MDD (SMD = À0.64; 95%-CI = À0.88, À0.40; I 2 = 51%; N = 597) and as monotherapy (SMD = À0.41; 95%-CI = À0.60, À0.22; I 2 = 93%, N = 8825). Antiinflammatory add-on improved response (RR = 1.76; 95%-CI = 1.44-2.16; I 2 = 16%; N = 341) and remission (RR = 2.14; 95%-CI = 1.03-4.48; I 2 = 57%; N = 270). We found a trend toward an increased risk for infections, and all studies showed high risk of bias. Conclusion: Anti-inflammatory agents improved antidepressant treatment effects. Future RCTs need to include longer follow-up, identify optimal doses and subgroups of patients that can benefit from anti-inflammatory intervention. Summations• Among 36 RCTs including almost 10 000 patients, five out of six anti-inflammatory drugs improved depression scores compared to placebo.• Short-term (i.e., weeks) anti-inflammatory add-on to antidepressants showed improved antidepressant effects in MDD without increasing the risk for side-effects.• The effect size for anti-inflammatory add-on to antidepressants was similar to the effect size of antidepressants alone, indicating the potential clinical benefit. Considerations• Few studies reported on side-effects and all studies were associated with risk of bias.• Few studies investigated biomarkers and none explored specific depressive symptoms to predict better response to anti-inflammatory treatment.• Hence, future studies need to include longer follow-up and measures of inflammation (blood, CSF, and brain scans) to identify subgroups of patients with specific depressive symptoms who could be offered anti-inflammatory treatment.

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Section: Resultsmentioning

confidence: 99%

Efficacy of anti‐inflammatory treatment on major depressive disorder or depressive symptoms: meta‐analysis of clinical trials

Köhler‐Forsberg

Lydholm

Hjorthøj

et al. 2019

Acta Psychiatr Scand

296

207

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“…A double-blind trial using lovastatin as an adjunct to fluoxetine showed a more significant reduction of depression on the Hamilton Depression Scale in the treatment group when compared to the control [85]. A further double-blind trial showed that adjuvant atorvastatin with citalopram produced a more pronounced antidepressant effect than citalopram alone, supporting the idea that statins can help reduce depressive symptoms [86]. Furthermore, statin use in general is associated with a 32% lower risk of developing depression [87].…”

Section: Cholesterolmentioning

confidence: 99%

The Role of Lipid Biomarkers in Major Depression

et al. 2017

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In the UK, the lifetime-documented prevalence of major depressive disorder (MDD) is currently 10%. Despite its increasing prevalence and devastating impact on quality of life, the pathophysiological mechanisms underpinning MDD remain to be fully elucidated. Current theories of neurobiological components remain incomplete and protein-centric, rendering pharmacological treatment options suboptimal. In this review, we highlight the pivotal role of lipids in intra- and inter-neuronal functioning, emphasising the potential use of lipids as biomarkers for MDD. The latter has significant implications for improving our understanding of MDD at the cellular and circuit level. There is particular focus on cholesterol (high and low density lipoprotein), omega-3, and omega-6 polyunsaturated fatty acids due to established evidence in the literature of a link between atherosclerotic disease and major depression. We argue that there is significant potential scope for the use of such peripheral biomarkers in the diagnosis, stratification and treatment of MDD.

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“…In a placebo controlled clinical trial, augmentation of citalopram with atorvastatin improved depressive symptoms assessed with the Hamilton depression rating scale [156]. Also a GLP-1 analogue therapy, i.e.…”

Section: Experimental Medications Focusing Primarily On Metabolic Aspmentioning

confidence: 99%

Nutritional Aspects of Depression

Lang

Beglinger

Schweinfurth

et al. 2015

Cell Physiol Biochem

212

134

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Several nutrition, food and dietary compounds have been suggested to be involved in the onset and maintenance of depressive disorders and in the severity of depressive symptoms. Nutritional compounds might modulate depression associated biomarkers and parallel the development of depression, obesity and diabetes. In this context, recent studies revealed new mediators of both energy homeostasis and mood changes (i.e. IGF-1, NPY, BDNF, ghrelin, leptin, CCK, GLP-1, AGE, glucose metabolism and microbiota) acting in gut brain circuits. In this context several healthy foods such as olive oil, fish, fruits, vegetables, nuts, legumes, poultry, dairy and unprocessed meat have been inversely associated with depression risk and even have been postulated to improve depressive symptoms. In contrast, unhealthy western dietary patterns including the consumption of sweetened beverage, refined food, fried food, processed meat, refined grain, and high fat diary, biscuits, snacking and pastries have been shown to be associated with an increased risk of depression in longitudinal studies. However, it is always difficult to conclude a real prospective causal relationship from these mostly retrospective studies as depressed individuals might also change their eating habits secondarily to their depression. Additionally specific selected nutritional compounds, e.g. calcium, chromium, folate, PUFAs, vitamin D, B12, zinc, magnesium and D-serine have been postulated to be used as ad-on strategies in antidepressant treatment. In this context, dietary and lifestyle interventions may be a desirable, effective, pragmatical and non-stigmatizing prevention and treatment strategy for depression. At last, several medications (pioglitazone, metformin, exenatide, atorvastatin, gram-negative antibiotics), which have traditionally been used to treat metabolic disorders showed a certain potential to treat depression in first randomized controlled clinical trials.

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In a randomized, double-blind clinical trial, adjuvant atorvastatin improved symptoms of depression and blood lipid values in patients suffering from severe major depressive disorder

Cited by 63 publications

References 30 publications

Efficacy of anti‐inflammatory treatment on major depressive disorder or depressive symptoms: meta‐analysis of clinical trials

Efficacy of anti‐inflammatory treatment on major depressive disorder or depressive symptoms: meta‐analysis of clinical trials

The Role of Lipid Biomarkers in Major Depression

Nutritional Aspects of Depression

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