Chunk #83 — Comorbidity of Post-traumatic stress disorder or major depressive disorder with alcohol use disorder and immune signaling — Major depressive disorder and alcohol use disorder
A proof-of concept study for a role for neuroimmune signaling in depression examined infliximab (a TNF-α inhibitor) in patients with treatment-resistant depression (Raison et al., 2013). Twelve weeks after the initiation of therapy, infliximab reduces depressive symptoms by at least half among patients with baseline CRP levels > 5 mg/L, but not among those with lower baseline levels (Raison et al., 2013). Another trial showed that adjunctive treatment with celecoxib, an anti-inflammatory drug that selectively inhibits COX2, is more effective in reducing depressive symptoms than sertraline alone in patients with MDD (Abbasi et al., 2012). A reduction of serum IL-6 levels also correlates with a reduction in the depression score, suggesting that cytokine levels correlate with depression severity and possibly treatment efficacy (Abbasi et al., 2012). Meta-analysis of clinical trials using anti-cytokine treatments indicate that these treatments persistently improved symptoms of depression (Kappelmann et al., 2016). Moreover, the PDE inhibitor ibudilast attenuates the stimulant and mood-altering effects of alcohol in patients with greater symptoms of depression, which may have relevance for treating MDD/AUD comorbid populations (Ray et al., 2017). Finally,
