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Augmentation therap...
Augmentation therapy with minocycline in treatment-resistant depression patients with low-grade peripheral inflammation: results from a double-blind randomised clinical trial
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Nettis, MA (author)
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Lombardo, G (author)
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Hastings, C (author)
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Zajkowska, Z (author)
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Mariani, N (author)
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Nikkheslat, N (author)
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Worrell, C (author)
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- Enache, D (author)
- Karolinska Institutet
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McLaughlin, A (author)
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Kose, M (author)
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Sforzini, L (author)
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Bogdanova, A (author)
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Cleare, A (author)
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Young, AH (author)
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Pariante, CM (author)
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Mondelli, V (author)
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(creator_code:org_t)
- 2021-01-28
- 2021
- English.
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In: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. - : Springer Science and Business Media LLC. - 1740-634X. ; 46:5, s. 939-948
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Abstract
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- This study aimed to investigate the role of baseline levels of peripheral inflammation when testing the efficacy of antidepressant augmentation with minocycline in patients with treatment-resistant depression. We conducted a 4-week, placebo-controlled, randomised clinical trial of minocycline (200 mg/day) added to antidepressant treatment in 39 patients selected for elevated levels of serum C-reactive protein (CRP ≥ 1 mg/L), n = 18 randomised to minocycline (M) and n = 21 to placebo (P). The main outcome was the change in Hamilton Depression Rating Scale (HAM-D-17) score from baseline to week 4, expressed both as mean and as full or partial response, in the overall sample and after further stratification for baseline CRP≥3 mg/L. Secondary outcomes included changes in other clinical and inflammatory measures. Changes in HAM-D-17 scores and the proportion of partial responders did not differ between study arms. After stratification for CRP levels <3 mg/L (CRP−) or ≥3 mg/L (CRP+), CRP+/M patients showed the largest changes in HAM-D-17 scores (mean ± SD = 12.00 ± 6.45) compared with CRP-/M (2.42 ± 3.20, p < 0.001), CRP+/P (3.50 ± 4.34, p = 0.003) and CRP−/P (2.11 ± 3.26, p = 0.006) patients, and the largest proportion (83.3%, p = 0.04) of partial treatment response at week 4. The threshold point for baseline CRP to distinguish responders from non-responders to minocycline was 2.8 mg/L. Responders to minocycline had higher baseline IL-6 concentrations than non-responders (p = 0.03); IFNγ was significantly reduced after treatment with minocycline compared with placebo (p = 0.03). Our data show some evidence of efficacy of add-on treatment with minocycline in MDD patients but only in those with low-grade inflammation defined as CRP ≥3 mg/L.
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- By the author/editor
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Nettis, MA
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Lombardo, G
-
Hastings, C
-
Zajkowska, Z
-
Mariani, N
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Nikkheslat, N
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show more...
-
Worrell, C
-
Enache, D
-
McLaughlin, A
-
Kose, M
-
Sforzini, L
-
Bogdanova, A
-
Cleare, A
-
Young, AH
-
Pariante, CM
-
Mondelli, V
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show less...
- Articles in the publication
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Neuropsychopharm ...
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Neuropsychopharm ...
- By the university
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Karolinska Institutet