title: Effect of celecoxib add-on treatment on symptoms and serum IL-6 concentrations in patients with major depressive disorder: randomized double-blind placebo-controlled study.
abstract: BACKGROUND
  It has been proposed that the mechanism of the antidepressant effect of celecoxib is linked to its anti-inflammatory action and particularly its inhibitory effect on pro-inflammatory cytokines (e.g. interleukin-6(IL-6)). We measured changes in serum IL-6 concentrations and depressive symptoms following administration of celecoxib in patients with major depressive disorder (MDD).
  
  
  METHODS
  In a randomized double-blind placebo-controlled study, 40 patients with MDD and Hamilton Depression Rating Scale-17 items (Ham-D) score ≥18 were randomly assigned to either celecoxib (200mg twice daily) or placebo in addition to sertraline (200mg/day) for 6 weeks. Outcome measures were serum IL-6 concentrations at baseline and week 6, and Ham-D scores at baseline and weeks 1, 2, 4, and 6.
  
  
  RESULTS
  The celecoxib group showed significantly greater reduction in serum IL-6 concentrations (mean difference (95%CI)=0.42(0.30 to 0.55) pg/ml, t(35)=6.727, P<0.001) as well as Ham-D scores (mean difference (95%CI)=3.35(1.08 to 5.61), t(38)=2.99, P=0.005) than the placebo group. The patients in the celecoxib group experienced more response (95%) and remission (35%) than the placebo group (50% and 5%, P=0.003 and 0.04 respectively). Baseline serum IL-6 levels were significantly correlated with baseline Ham-D scores (r=0.378, P=0.016). Significant correlation was observed between reduction of Ham-D scores and reduction of serum IL-6 levels at week 6 (r=0.673, P<0.001).
  
  
  CONCLUSIONS
  We did not measure other inflammatory biomarkers.
  
  
  CONCLUSIONS
  We showed that the antidepressant activity of celecoxib might be linked to its capability of reducing IL-6 concentrations. Moreover, supporting previous studies we showed that celecoxib is both safe and effective as an adjunctive antidepressant (Registration number: IRCT138903124090N1).
authors.affiliation: Family Health Research Center, Iranian Petroleum Industry Health Research Institute, NIOC Central Hospital, Tehran, Iran.
authors.forename: Seyed-Hesameddin
authors.initials: SH
authors.lastname: Abbasi
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Hosseini
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Modabbernia
authors.forename: Mandana
authors.initials: M
authors.lastname: Ashrafi
authors.forename: Shahin
authors.initials: S
authors.lastname: Akhondzadeh
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D000068579:Celecoxib; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011720:Pyrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D015415:Biomarkers; D015850:Interleukin-6; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib; D020280:Sertraline