Inflamed moods: A review of the interactions between inflammation and mood disorders

Date
2014-08-04Author
Rosenblat, Joshua D.
Cha, Danielle S.
Mansur, Rodrigo B. [UNIFESP]
McIntyre, Roger S.
Type
ResenhaISSN
0278-5846Is part of
Progress in Neuro-psychopharmacology & Biological PsychiatryDOI
10.1016/j.pnpbp.2014.01.013Metadata
Show full item recordAbstract
Mood disorders have been recognized by the World Health Organization (WHO) as the leading cause of disability worldwide. Notwithstanding the established efficacy of conventional mood agents, many treated individuals continue to remain treatment refractory and/or exhibit clinically significant residual symptoms, cognitive dysfunction, and psychosocial impairment. Therefore, a priority research and clinical agenda is to identify pathophysiological mechanisms subserving mood disorders to improve therapeutic efficacy.During the past decade, inflammation has been revisited as an important etiologic factor of mood disorders. Therefore, the purpose of this synthetic review is threefold: 1) to review the evidence for an association between inflammation and mood disorders, 2) to discuss potential pathophysiologic mechanisms that may explain this association and 3) to present novel therapeutic options currently being investigated that target the inflammatory-mood pathway.Accumulating evidence implicates inflammation as a critical mediator in the pathophysiology of mood disorders. Indeed, elevated levels of pro-inflammatory cytokines have been repeatedly demonstrated in both major depressive disorder (MDD) and bipolar disorder (BD) patients. Further, the induction of a pro-inflammatory state in healthy or medically ill subjects induces 'sickness behavior' resembling depressive symptomatology.Potential mechanisms involved include, but are not limited to, direct effects of pro-inflammatory cytokines on monoamine levels, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, pathologic microglial cell activation, impaired neuroplasticity and structural and functional brain changes.Anti-inflammatory agents, such as acetyl-salicylic acid (ASA), celecoxib, anti-TNF-alpha agents, minocycline, curcumin and omega-3 fatty acids, are being investigated for use in mood disorders. Current evidence shows improved outcomes in mood disorder patients when anti-inflammatory agents are used as an adjunct to conventional therapy; however, further research is needed to establish the therapeutic benefit and appropriate dosage. (C) 2014 Elsevier Inc. All rights reserved.
Citation
Progress in Neuro-psychopharmacology & Biological Psychiatry. Oxford: Pergamon-Elsevier B.V., v. 53, p. 23-34, 2014.Keywords
Bipolar disorderCytokines
Inflammation
Major depressive disorder
Mood disorder
Non-steroidal anti-inflammatory drug (NSAID)
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