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J Psychopharmacol. 2017 Sep;31(9):1166-1175. doi: 10.1177/0269881117724352. Epub 2017 Aug 31.

Minocycline as an adjunct for treatment-resistant depressive symptoms: A pilot randomised placebo-controlled trial.

Author information

1
1 Camden and Islington NHS Foundation Trust, London, UK.
2
2 Pakistan Institute of Living and Learning, Karachi, Pakistan.
3
3 University of Manchester, Manchester, UK.
4
4 Dow University of Health Sciences, Karachi, Pakistan.
5
5 Abbasi Shaheed Hospital, Karachi, Pakistan.
6
6 Institute of Psychiatry, King's College London, London, UK.
7
7 Mersey Care NHS Foundation Trust, Liverpool, UK.
8
8 University of Manchester, Manchester, UK.

Abstract

BACKGROUND:

Evidence suggests that anti-inflammatory medication may be effective in the treatment of depressive symptoms. In this study, we aimed to investigate whether minocycline added to treatment as usual (TAU) for 3 months in patients with treatment-resistant depression will lead to an improvement in depressive symptoms.

METHODS:

Multi-site, 12-week, double-blind, placebo-controlled, pilot trial of minocycline added to TAU for patients suffering from DSM-5 major depressive disorder, whose current episode has failed to respond to at least two antidepressants. The primary outcome measure was mean change in Hamilton Depression Rating Scale (HAMD-17) scores from baseline to week 12. Secondary measures were the Clinical Global Impression scale (CGI), Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder scale (GAD-7) and EuroQoL (EQ-5D) quality-of-life questionnaire. Side-effect checklists were also used. Minocycline was started at 100 mg once daily (OD) and increased to 200 mg after 2 weeks.

RESULTS:

A total of 41 participants were randomised, with 21 in the minocycline group and 20 in the placebo group. A large decrease in HAMD scores was observed in the minocycline group compared to the placebo group (standardised effect size (ES) -1.21, p < 0.001). CGI scores in the minocycline group also showed a large improvement compared with placebo (odds ratio (OR): 17.6, p < 0.001). PHQ-9, GAD-7 and EQ-5D total showed more moderate improvements (ES ~ 0.4-0.5).

CONCLUSION:

The findings indicate that adjunctive minocycline leads to improvement in symptoms of treatment-resistant depression. However, our findings require replication in a larger sample.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT02263872, registered October 2014.

KEYWORDS:

Inflammation; depression; minocycline

PMID:
28857658
DOI:
10.1177/0269881117724352
[Indexed for MEDLINE]

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