Background
Depression remains an unresolved issue on a global scale. Recently, a novel concept of ‘anti-inflammatory-based pharmacotherapy’ has been developed. Despite the role of inflammation in depression having been discussed in many reviews at various levels, the prevalence of this new concept in randomised controlled clinical studies and its implications remain elusive. The aim of this scoping review was precisely to explore in depth the current status of inflammation in randomised controlled clinical trial studies of depression.
Methods
PubMed was systematically searched from inception to December 11 2024. Studies that researches on the treatment of depression based on anti-inflammatory strategies were included. Study characteristics and outcomes were extracted and organized thematically.
Findings
11 reports of randomised controlled clinical trials were included, which accumulated 907 depressed patients. All studies found that there is a connection between the effects of anti-inflammatory drugs in treating depression and a large decrease in the levels of inflammatory markers in the blood of depressed patients compared to before treatment. Three inflammatory markers, CRP, IL-6 and TNF-alpha, were the most frequently mentioned. The current strategy of anti-inflammatory drug administration did not differ fundamentally from the previous strategy of traditional antidepressant drugs combined with psychotherapy.
Interpretation
At present, the use of anti-inflammatory strategies for the pharmacological treatment of depression has limited research value and poor feasibility. The future direction of the new concept of anti-inflammatory strategies for the treatment of depression, proposed in the context of the association between inflammation and depression, is that psychiatrists, researchers, and psychotherapists should shift their future focus from pharmacological treatments based on anti-inflammatory strategies to non-pharmacological treatments of anti-inflammatory strategies, such as positive thinking, exercise, and so on. The popularity of purely clinical randomised controlled studies in the depression population is extremely low when considering the financial investment in research and the benefits of translating the results. In the future, public interest studies, low research costs, and research protocols with mass generalisability will be more likely to stimulate the depression community’s interest in participating in research. The potential value and feasibility of future research lies in the application of an integrated AI platform to assist pharmacological treatment of depression based on anti-inflammatory strategies.
Registration DOI: https://doi.org/10.17605/OSF.IO/A64GC .