Minocycline and celecoxib as adjunctive treatments for bipolar depression: a multicentre, factorial design randomised controlled trial

This 12 week RCT (n=266 in Pakistan) casts doubt on the potential therapeutic benefits of adjunctive anti-inflammatory drugs for the acute management of bipolar depression as it found no evidence minocycline or celecoxib was superior to placebo in this population.

SPS commentary:

According to a commentary, it is arguably ambitious at the outset to expect a singular biological therapy targeting one biological marker of the disorder to address all phenotypes of this heterogeneous clinical presentation. It suggests the complexity of bipolar depression might be an explanation more broadly for the relatively common failure of singular treatment approaches, and polyvalent and personalised therapies predicated on individualised profiles are needed to select from the diverse pharmacological, neurostimulatory, nutraceutical, lifestyle, and psychological approaches that are available. It concludes that notwithstanding the methodological issues that accompany any clinical trial, the promise of targeting the inflammation pathway in the management of this challenging condition is today somewhat weaker.


The Lancet Psychiatry

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