Psychosocial interventions (eg, mindfulness-based therapies) exert anti-inflammatory effects and beneficial for individuals who have been affected by trauma, which in itself may be an antecedent to mood disorders s well as a proinflammatory trigger. In addition, the significant contribution of comorbidity (eg, obesity) to inflammation invites the need to specifically target these conditions when present, reiterating the emphasis on the need for treating the entire patient.
Currently no anti-inflammatory agent can be considered as being ready for “prime time” or highly recommended for use in persons with mood disorders either along with, or adjunctive to other agents. Instead, select anti-inflammatory agents should be considered promising, with a need for more evidence to establish efficacy, short- and long-term safety, as well as to identify which populations are more-or-less likely to respond.
It is not without interest, however, that preliminary data suggest that short-term exposure to minocycline, liraglutide, omega-3 fatty acids, as well as ketamine and L-methylfolate, may be preferentially effective in patients with a proinflammatory balance. Rigorous studies are needed to evaluate dietary interventions that specifically target the gut enterotype as potentially anti-inflammatory and anti-depressant/pro-cognitive.
From a population health perspective, it would be propitious to evaluate the effect of “anti-inflammatory approaches” such as the removal of soft drink machines from public schools on brain health, as well as a fuller characterization of the proinflammatory effects of urbanization, social isolation, and climate change on incident depression. Climate change is particularly relevant in some parts of the world, with emerging evidence that links air pollution and suicidality.
Dr. McIntyre reports that he is on the Speakers Bureau for AstraZeneca, Bristol-Myers Squibb, Janssen-Ortho, Eli Lilly, Lundbeck, Pfizer, Shire, Otsuka, Purdue, Takeda, and Allergan; he has received research support/grants from Stanley Medical Research Institute, National Alliance for Research on Schizophrenia and Depression (NARSAD), and National Institutes of Mental Health. Dr. Rong reports no conflicts of interest concerning the subject matter of this article.
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