Efficacy of Celecoxib Adjunct Treatment on Bipolar Disorder: Systematic Review and Meta-Analysis

Author(s): Daniela V. Bavaresco, Tamy Colonetti, Antônio J. Grande, Francesc Colom, Samira S. Valvassori, João Quevedo, Maria I. da Rosa*.

Journal Name: CNS & Neurological Disorders - Drug Targets

Volume 18 , Issue 1 , 2019

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Graphical Abstract:


Abstract:

Background: Bipolar Disorder (BD) is a psychiatric disorder characterized by mood disturbances. The pathophysiology of BD is still poorly understood. In the last years, research studies focused on the role of inflammation in BD.

Objective: Performed a systematic review and meta-analysis to evaluate the potential effect of the cyclo- oxygenases (Cox)-2 inhibitor Celecoxib adjunct treatment in BD through randomized controlled trials (RCT).

Methods: A search on the electronic databases was proceeded, on MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science, IBECS, LILACS, PsycINFO, Congress Abstracts, and Grey literature (Google Scholar and the British Library) for studies published from January 1990 to February 2018. A search strategy was developed using the terms: “Bipolar disorder” or “Bipolar mania” or “Bipolar depression” or “Bipolar mixed” or “Bipolar euthymic” and “Celecoxib” or “Cyclooxygenase-2 inhibitors” or “Cox-2 inhibitors” as text words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched. The therapeutic effects of adjunctive treatment with Celecoxib were analyzed. The meta-analysis was performed including the results of the Young Mania Rating Scale (YMRS) at the end of RCT.

Results: Three primary studies were included in the systematic review, with a total of 121 patients. The meta-analysis showed a significant effect on the YMRS scores from patients with BD who used Celecoxib adjuvant treatment in comparison to placebo.

Conclusion: The systematic review suggests that adjuvant treatment with Celecoxib improves the response of major treatments in patients with BD when compared with adjuvant placebo treatment.

Systematic Review Registration Number: The review protocol was registered at PROSPERO (registration number: CRD42017067635); in June 06 2017.

Keywords: Bipolar disorder, Cox-2 inhibitors, celecoxib, systematic review, meta-analysis, mania, hypomania.

[1]
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 2013;. 5th ed.
[2]
Nierenberg AA, Ostacher MJ, Calabrese JR, et al. Treatment-resistant bipolar depression: A STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. Am J Psychiatry 2006; 163: 210-6.
[3]
Kessler RC, Akiskal HS, Ames M, Birnbaum H, Greenberg P, Hirschfeld RM. Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. Am J Psychiatry 2006; 163: 1561-8.
[4]
Clemente AS, Diniz BS, Nicolato R, et al. Bipolar disorder prevalence: A systematic review and meta-analysis of the literature. Rev Bras Psiquiatr 2015; 37: 155-61.
[5]
Serafini G, Pompili M, Borgwardt S, et al. Brain changes in early-onset bipolar and unipolar depressive disorders: A systematic review in children and adolescents. Eur Child Adolesc Psychiatry 2014; 23: 1023-41.
[6]
Rizzo LB, Costa LG, Mansur RB, et al. The theory of bipolar disorder as an illness of accelerated aging: Implications for clinical care and research. Neurosci Biobehav Rev 2014; 42: 157-69.
[7]
Barbosa IG, Machado-Vieira R, Soares JC, Teixeira AL. The immunology of bipolar disorder. Neuroimmunomodulation 2014; 21: 117-22.
[8]
Barbosa IG, Bauer ME, Machado-Vieira R, Teixeira AL. Cytokines in bipolar disorder: Paving the way for neuroprogression. Neural Plast 2014; 360-481.
[9]
Berk M, Kapczinski F, Andreazza AC, et al. Pathways underlying neuroprogression in bipolar disorder: Focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev 2011; 35: 804-17.
[10]
Rao JS, Harry GJ, Rapoport SI, Kim HW. Increased excitotoxicity and neuroinflammatory markers in postmortem frontal cortex from bipolar disorder patients. Mol Psychiatry 2010; 15(4): 384-92.
[11]
Modabbernia A, Taslimi S, Brietzke E, Ashrafi M. Cytokine alterations in bipolar disorder: A meta-analysis of 30 studies. Biol Psychiatry 2013; 74: 15-25.
[12]
Munkholm K, Braüner JV, Kessing LV, Vinberg M. Cytokines in bipolar disorder vs. healthy control subjects: A systematic review and meta-analysis. J Psychiatr Res 2013; 47: 1119-33.
[13]
Silverman MN, Pearce BD, Biron CA, Miller AH. Immune modulation of the hypothalamic-pituitary-adrenal (HPA) axis during viral infection. Viral Immunol 2005; 18: 41-78.
[14]
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet 2013; 381: 1672-82.
[15]
Soares JC. Recent advances in the treatment of bipolar mania, depression, mixed states, and rapid cycling. Int Clin Psychopharmacol 2000; 15: 183-96.
[16]
Ketter TA, Sarma K, Silva R, Kroger H, Cucchiaro J, Loebel A. Lurasidone in the long-term treatment of patients with bipolar disorder: A 24-week open-label extension study. Depress Anxiety 2016; 33: 424-34.
[17]
Valvassori SS, Resende WR, Dal-Pont G, et al. Lithium ameliorates sleep deprivation-induced mania-like behavior, hypothalamic-pituitary-adrenal (HPA) axis alterations, oxidative stress and elevations of cytokine concentrations in the brain and serum of mice. Bipolar Disord 2017; 19: 246-58.
[18]
Valvassori SS, Tonin PT, Varela RB, et al. Lithium modulates the production of peripheral and cerebral cytokines in an animal model of mania induced by dextroamphetamine. Bipolar Disord 2015; 17: 507-17.
[19]
Arabzadeh S, Ameli N, Zeinoddini A, et al. Celecoxib adjunctive therapy for acute bipolar mania: A randomized, double-blind, placebo-controlled trial. Bipolar Disord 2015; 17: 606-14.
[20]
Husain MI, Strawbridge R, Stokes PR, Young AH. Anti-inflammatory treatments for mood disorders: Systematic review and meta-analysis. J Psychopharmacol 2017; 31: 1137-48.
[21]
Mousavi SY, Khezri R, Karkhaneh-Yousefi MA, et al. Randomized double-blind placebo-controlled trial on effectiveness and safety of celecoxib adjunctive therapy in adolescents with acute bipolar mania. J Child Adolesc Psychopharmacol 2017; 27: 494-500.
[22]
Marnett LJ, Rowlinson WS, Goodwin DC, Kalgutkar AS, Lanzo CA. Arachidonic acid oxygenation by COX-1 and COX-2. J Biol Chem 1999; 274: 22903-6.
[23]
Brooks P, Emery P, Evans JF, et al. Interpreting the clinical significance of the diferential inhibition of cyclooxygenase-1 and cyclooxygenase-2. Rheumatology 1999; 38: 779-88.
[24]
Perazella MA, Tray K. Selective cyclooxygenase-2 inhibitors: A pattern of nephrotoxicity similar to traditional nosteroidal anti-inflammatory drugs. Am J Med 2001; 111: 64-7.
[25]
Yaksh TL, Dirig DM, Conway CM, Svensson C, Luo ZD, Isakson PC. The acute antihyperalgesic action of nonsteroidal, anti-inflammatory drugs and release of spinal prostaglandin E2 is mediated by the inhibition of constitutive spinal cyclooxygenase-2 (COX-2) but not COX-1. J Neurosci 2001; 21: 5847-53.
[26]
Cannon GW, Breedveld FC. Efficacy of cyclooxygenase-2 specific inhibitors. Am J Med 2001; 110: 6-12.
[27]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic review and meta-analysis of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ 2009; 339: b2700.
[28]
Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration..
[29]
Dersimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177-88.
[30]
Kargar M, Yousefi A, Mojtahedzadeh M, et al. Effects of celecoxib on inflammatory markers in bipolar patients undergoing electroconvulsive therapy: A placebo-controlled, double-blind, randomised study. Swiss Med Wkly 2014; 144: w13880.
[31]
Kargar M, Yoosefi A, Akhondzadeh S, Artonian V, Ashouri A, Ghaeli P. Effect of adjunctive celecoxib on BDNF in manic patients undergoing electroconvulsive therapy: A randomized double blind controlled trial. Pharmacopsychiatry 2015; 48: 268-73.
[32]
Nery FG, Monkul ES, Hatch JP, et al. Celecoxib as an adjunct in the treatment of depressive or mixed episodes of bipolar disorder: A double-blind, randomized, placebo-controlled study. Hum Psychopharmacol 2008; 23: 87-94.
[33]
Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomized controlled trials. BMJ 2011; 343: d4002.
[34]
Brietzke E, Mansur RB, Soczynska JK, Kapczinski F, Bressan RA, McIntyre RS. Towards a multifactorial approach for prediction of bipolar disorder in at risk populations. J Affect Disord 2012; 140: 82-91.
[35]
Barrientos R, Kitt MM, Watkins LR, Maier SF. Neuroinflammation in the normal aging hippocampus. Neuroscience 2015; 19(309): 84-99.
[36]
Lima RR, Costa AMR, Souza RD, Gomesleal W. Inflamation in neurodegenerative disease. Rev Para Med 2007; 21: 29-34.
[37]
Felger JC, Alagbe O, Hu F. Effects of interferon-alpha on rhesus monkeys: A nonhuman primate model of cytokine-induced depression. Biol Psychiatry 2007; 62(11): 1324-33.
[38]
Miller AH, Maletic V, Raison CL. Inflammation and its discontents: The role of cytokines in the pathophysiology of major depression. Biol Psychiatry 2009; 65(9): 732-41.
[39]
Miller AH, Haroon E, Raison CL, Felger JC. Cytokine targets in the brain: Impact on neurotransmitters and neurocircuits. Dep Anx 2013; 30: 297-306.
[40]
Zambalde ÉP, Teixeira MM, Favarin DC, et al. The anti-inflammatory and pro-resolution effects of aspirin-triggered RvD1 (AT-RvD1) on peripheral blood mononuclear cells from patients with severe asthma. Int Immunopharmacol 2016; 35: 142-8.
[41]
Goncharova LB, Tarakanov AO. Molecular networks of brain and immunity. Brain Res Rev 2007; 55: 155-66.
[42]
Muller N, Schwarz MJ. Immune system and schizophrenia. Curr Immunol Rev 2010; 6: 213-20.
[43]
Barbosa IG, Huguet RB, Neves FS, Bauer ME, Teixeira AL. Immunology of bipolar disorder. J Bras Psiquiatr 2009; 58: 52-9.
[44]
Abbasi SH, Hosseini F, Modabbernia A, Ashrafi M, Akhondzadeh S. Effect of celecoxib add-on treatment on symptoms and serum IL-6 concentrations in patients with major depressive disorder: Randomized double-blind placebo-controlled study. J Affect Disord 2012; 141: 308-14.
[45]
Chen CY, Tzeng NS, Chen YC. Maintenance therapy of celecoxib for major depression with mimicking neuropsychological dysfunction. Gen Hosp Psychiatry 2010; 32: 647.
[46]
Faridhosseini F, Sadeghi R, Farid L, Pourgholami M. Celecoxib: A new augmentation strategy for depressive mood episodes. A systematic review and meta-analysis of randomized placebo-controlled trials. Hum Psychopharmacol 2014; 29: 216-23.
[47]
Borre Y, Lemstra S, Westphal KG, Morgan ME, Olivier B, Oosting RS. Celecoxib delays cognitive decline in an animal model of neurodegeneration. Behav Brain Res 2012; 234: 285-91.
[48]
Casolini P, Catalani A, Zuena AR, Angelucci L. Inhibition of COX-2 reduces the age-dependent increase of hippocampal inflammatory markers, corticosterone secretion, and behavioral impairments in the rat. J Neurosci Res 2002; 68: 337-43.
[49]
Mirjany M, Ho L, Pasinetti GM. Role of cyclooxygenase-2 in neuronal cell cycle activity and glutamate-mediated excitotoxicity. J Pharmacol Exp Ther 2002; 301: 494-500.
[50]
Raison CL, Capuron L, Miller AH. Cytokines sing the blues: Inflammation and the pathogenesis of depression. Trends Immunol 2006; 27: 24-31.
[51]
Ross BM, Brooks RJ, Lee M, et al. Cyclooxygenase inhibitor modulation of dopamine-related behaviours. Eur J Pharmacol 2002; 450: 141-51.
[52]
Hope S, Dieset I, Agartz I, et al. Affective symptoms are associated with markers of inflammation and immune activation in bipolar disorders but not in schizophrenia. J Psychiatr Res 2011; 45: 1608-16.
[53]
Husain MI, Chaudhry IB, Hamirani MM, et al. Minocycline and celecoxib as adjunctive treatments for bipolar depression: A study protocol for a multicenter factorial design randomized controlled trial. Neuropsychiatr Dis Treat 2016; 13: 1-8.
[54]
Subramaniam M, Abdin E, Vaingankar JA, et al. Impact of psychiatric disorders and chronic physical conditions on health-related quality of life: Singapore mental health study. J Affect Disord 2013; 147(1-3): 325-30.
[55]
Ferrari AJ, Norman RE, Freedman G, et al. The burden attributable to mental and substance use disorders as risk factors for suicide: Findings from the Global Burden of Disease Study 2010. PLoS One 2014; 29(4): e91936.
[56]
García-Rayado G, Navarro M. Lanas A4. NSAID induced gastrointestinal damage and designing GI-sparing NSAIDs. Expert Rev Clin Pharmacol 2018.
[http://dx.doi.org/10.1080/17512433.2018.1516143]


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Article Details

VOLUME: 18
ISSUE: 1
Year: 2019
Page: [19 - 28]
Pages: 10
DOI: 10.2174/1871527317666181105162347
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