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Table 3 Selected studies assessing the efficacy of antiinflammatory agents among patients with unipolar and bipolar depression, schizophrenia, and obsessive-compulsive disorder

From: Neuroinflammation and psychiatric illness

Study Study design Group comparison Number of subjects Functional outcome
COX-2 inhibitors     
  Müller et al. 2006 [238] RCT Celecoxib (200 mg bid) + reboxetine versus placebo + reboxetine 40 MDD (acute) Significantly greater decrease in depressive symptoms in the treatment group (P = 0.035)
  Akhondzadeh et al. 2009 [239] RCT Celecoxib (200 mg bid) + fluoxetine versus placebo + fluoxetine 40 MDD Significant improvement of depressive symptoms (P <0.001), and a greater percentage of responders (90% versus 50%, P = 0.01) and remission (35% versus 5%, P = 0.04) in the treatment group
  Medlewicz et al. 2006 [240] Open-label Acetylsalicylic acid (160 mg qd) + SRI 24 MDD and BPD 52.4% responder rate, significant improvement within one week (P <0.0001) following treatment; sustained at four weeks completed, pending results RCT Cimicoxib (50 mg bid) + sertraline versus placebo + sertraline 169 MDD Primary outcome measure is mean change in Hamilton Depression Rating Scale from baselineto six-week endpoint
  Nery et al. 2008 [263] RCT Celecoxib versus placebo 28 BPD (depressive and mixed states) No significant differences in depressive or manic symptoms.
  Müller et al. 2002 [242] RCT Celecoxib (400 mg qd) + risperidone versus placebo + risperidone 50 (acute schizophrenia) Significant improvement of positive and negative symptoms (P = 0.05), as well as cognition (P <0.06) in treatment group at five weeks
  Müller et al. 2010 [244] RCT Celecoxib + amisulpride versus placebo + amisulpride 49 schizophrenia (first-episode) Significant improvement of positive and negative symptoms in celecoxib plus amisulpride group relative to amisulpride alone (P <0.001) at six-weeks
  Sayyah et al. 2011 [245] RCT Celecoxib (200 mg bid) + fluoxetine versus placebo + fluoxetine 50 OCD Significantly greater reduction in YBOCS scores in the celecoxib treatment group at two weeks (P = 0.007) and at the eight week end-point (P = 0.037)
  Levine et al. 1996 [264] Case report Minocycline (150 mg qd) started 20 years after disease onset 1 BPD Marked decrease in depressive symptoms (HAM-D score went from 25 to 8) within one week following treatment, sustained at two weeks.
  Levkovitz et al. 2009 [265] RCT Minocycline (200 mg qd) versus placebo 21 schizophrenia (early and acute-phase) Significant improvement of negative symptoms and cognitive dysfunction in treatment group (P <0.01) NCT01433055 recruiting, estimated completion 7/15 RCT Minocycline (100 mg bid) + clozapine versus placebo + clozapine 60 schizophrenia (refractory to ≥2 antipsychotics) Primary outcome is the improvement in positive symptoms as measured by the four-item sub-factor of the Brief Psychiatric Rating Scale.
  Miyaoka et al. 2007 [266] Case series Minocycline (150 mg qd) + stable antipsychotic regiment 2 schizophrenia Complete resolution of positive and negative symptoms with minocycline, sustained for one to two years. Symptom exacerbation occurred one-week following minocycline discontinuation (in both cases). In one patient, the complete resolution of symptoms occurred at age 61, which was 41 years after disease onset.
  Miyaoka et al. 2008 [267] Open-label Minocycline (150 mg tid) 22 schizophrenia Significant improvement of positive and negative symptoms at four to eight weeks (P = 0.0001)
  Rodriguez et al. 2010 [268] Open-label Minocycline (100 mg bid) 9 OCD 22% had a 40% to 46% YBOCS reduction at 12 weeks; the group as a whole did not have a significant change in YBOCS score.
  1. ASA, acetylsalicylic acid; BPD, bipolar disorder; COX-2, cycloxygenase-2; HAM-D: Hamilton Depression Rating Scale; MDD, major depressive disorder; OCD, obsessive-compulsive disorder; SRI, serotonin reuptake inhibitor; RCT, randomized controlled trial; YBOCS: Yale-Brown Obsessive-Compulsive Scale.