title: Minocycline as adjunctive therapy for patients with unipolar psychotic depression: an open-label study.
abstract: BACKGROUND
  Approximately 25% of patients admitted to a hospital as a result of depression are actually suffering from psychotic depression. Psychotic symptoms can be present in patients with either unipolar depression or bipolar depression and can be difficult to treat. It was reported the second-generation tetracycline may exert potential antidepressant effects through its robust neuroprotective activities, which include neurogenesis, antioxidation, and anti-glutamate excitotoxicity, and may direct regulation of pro-inflammatory agents.
  
  
  METHODS
  This was a 6-week, open-label study to evaluate the efficacy and safety of minocycline in combination with antidepressants in adult inpatients (n=25) diagnosed with major depression with psychotic features (psychotic depression) according to DSM-IV-TR. The primary endpoint was the change from baseline in the Hamilton Depression Rating Scale (HAM-D-21) score from baseline to week 6. Secondary endpoints were changes in the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression (CGI) Scale scores from baseline to week 6. Spontaneously reported adverse events were recorded.
  
  
  RESULTS
  The patients' average age was 46.9±10.2 years. Minocyline (150 mg/day) in combination with antidepressants (fulvoxamine, paroxetine, and sertraline) provided significant improvement in depression. Mean (± SD) HAM-D-21 was reduced to 6.7±1.9 at week 6 from a baseline value of 40.4±2.5. Significant improvement of psychotic symptoms (mean±SD) was indicated by the decrease in BPRS scores from baseline (63.3±8.7) to week 6 (4.6±2.4). No serious adverse events occurred.
  
  
  CONCLUSIONS
  These preliminary data suggest that minocycline in combination with antidepressants is effective and well tolerated in the treatment of unipolar psychotic depression. Further studies using larger, double-blind, parallel-group design are warranted to confirm these findings.
authors.affiliation: Department of Psychiatry, Shimane University School of Medicine, Izumo, Japan. miyanyan@med.shimane-u.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Miyaoka
authors.forename: Rei
authors.initials: R
authors.lastname: Wake
authors.forename: Motohide
authors.initials: M
authors.lastname: Furuya
authors.forename: Kristian
authors.initials: K
authors.lastname: Liaury
authors.forename: Masa
authors.initials: M
authors.lastname: Ieda
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kawakami
authors.forename: Keiko
authors.initials: K
authors.lastname: Tsuchie
authors.forename: Michiyo
authors.initials: M
authors.lastname: Taki
authors.forename: Kotomi
authors.initials: K
authors.lastname: Ishihara
authors.forename: Tomoko
authors.initials: T
authors.lastname: Araki
authors.forename: Jun
authors.initials: J
authors.lastname: Horiguchi
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D008911:Minocycline