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Effect of anti-inflammatory treatment on depression, depressive symptoms, and adverse effects: a systematic review and meta-analysis of randomized clinical trials.

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TLDR
The analysis suggests that anti-inflammatory treatment, in particular celecoxib, decreases depressive symptoms without increased risks of adverse effects, and supports a proof-of-concept concerning the use of anti- inflammatory treatment in depression.
Abstract
with depression (SMD, −0.54; 95% CI, −1.08 to −0.01; I 2 = 68%) and depressive symptoms (SMD, −0.27; 95% CI, −0.53 to −0.01; I 2 = 68%). The heterogeneity of the studies was not explained by differences in inclusion of clinical depression vs depressive symptoms or use of NSAIDs vs cytokine inhibitors. Subanalyses emphasized the antidepressant properties of the selective cyclooxygenase 2 inhibitor celecoxib (SMD, −0.29; 95% CI, −0.49 to −0.08; I 2 =7 3%) on remission (OR, 7.89; 95% CI, 2.94 to 21.17; I 2 = 0%) and response (OR, 6.59; 95% CI, 2.24 to 19.42; I 2 = 0%). Among the 6 studies reporting on adverse effects, we found no evidence of an increased number of gastrointestinal or cardiovascular events after 6 weeks or infections after 12 weeks of anti-inflammatory treatment compared with placebo. All trials were associated with a high risk of bias owing to potentially compromised internal validity.

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The role of inflammation in depression: from evolutionary imperative to modern treatment target

TL;DR: Current understanding of the mechanisms by which the innate and adaptive immune systems interact with neurotransmitters and neurocircuits to influence the risk for depression are detailed.
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Major depressive disorder

TL;DR: An overview of the current evidence of major depressive disorder, including its epidemiology, aetiology, pathophysiology, diagnosis and treatment, is provided.
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A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression.

TL;DR: Overall, there were similarities in the pattern of cytokine alterations in schizophrenia, bipolar disorder and MDD during acute and chronic phases of illness, raising the possibility of common underlying pathways for immune dysfunction.
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Depression as a Microglial Disease

TL;DR: Some forms of depression can be considered as a microglia disease (microgliopathy), which should be treated by a personalized medical approach using microglial inhibitors or stimulators depending on the microglian status of the depressed patient.
References
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Journal ArticleDOI

Measuring inconsistency in meta-analyses

TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Book

Cochrane Handbook for Systematic Reviews of Interventions

TL;DR: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
Journal ArticleDOI

Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials.

TL;DR: Empirical evidence is provided that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias.
Journal ArticleDOI

From inflammation to sickness and depression: when the immune system subjugates the brain

TL;DR: In response to a peripheral infection, innate immune cells produce pro-inflammatory cytokines that act on the brain to cause sickness behaviour, which can lead to an exacerbation of sickness and the development of symptoms of depression in vulnerable individuals.
Book ChapterDOI

Assessing Risk of Bias in Included Studies

TL;DR: In this paper, the authors propose a new algorithm called 1.8.1.1-2.0-1.8-1/2.8/1/1.
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