Steroids and antidepressant response

Abstract

The recent meta-analytic review of trials involving anti-inflammatory agents to treat or to supplement treatment of patients with major depressive disorder (MDD) or depressive symptoms by Köhler-Forsberg and colleagues [1] includes data derived from 36 controlled trials. Treatments included glucocorticoids as well as cytokine inhibitors, minocycline, nonsteroidal anti-inflammatory drugs (NSAIDs), pioglitazone, and statins. There were 14 randomized, controlled trials involving addition of one of these agents versus placebo to standard antidepressants to treat acute episodes of MDD in 597 subjects. The resulting data analyzed by random-effects meta-analysis yielded a highly significant standardized mean drug-placebo difference (SMD) of -0.64 (95% CI: -0.88 to -0.40; z=5.17, p<0.00001) in which 9/14 trials (64.3%) individually yielded statistically significant differences, with moderate heterogeneity (I2 = 51%). This article is protected by copyright. All rights reserved.