Sep 4th 2017

We may be able to treat depression with anti-inflammatory drugs – here's why

There is growing evidence that inflammation – already known to be a cause of many whole-body diseases – is also involved in diseases of the brain, including psychiatric conditions like depression.

Depression is a common and crippling disease affecting over 350m people worldwide. Around 20% of the UK population will suffer from depression at some point in their lives, with symptoms varying from feelings of sadness and hopelessness through to suicidal thoughts. The disease may be a response to bereavement or other life events or emerge without any obvious cause. All too often it persists, sometimes for life.

Despite its high prevalence, the disease is poorly understood. It is often put down to a disturbance in brain chemistry and treated in a trial-and-error manner with talking therapies and drugs that are designed to re-balance brain chemistry. For many, these approaches eventually work, but all agree that better treatments are needed and these require a better understanding of the disease.

Beating two disorders with one pill

Inflammation is the body’s response to injury or infection. Cells and proteins are mobilised to deal with the injury, do their job and then are demobilised. However, inflammation, when not properly controlled, can cause damage and disease, such as rheumatoid arthritis. These types of diseases are often controlled with anti-inflammatory drugs.

Recently, it has been suggested that depression is also an inflammatory disease. The first evidence came from people with diseases like rheumatoid arthritis and psoriasis who were also severely depressed. When these people were treated with anti-inflammatories, both their arthritis and their depression improved, suggesting that inflammation in the body was affecting the brain to cause depression.

Of course, their depression may have improved because their other physical conditions had cleared up, but the evidence strengthened when it was shown that some people with depression, and no other disease, had increased levels of blood markers of inflammation. When their brains were looked at in the latest imaging machines, tell-tale signs of inflammation were present.

All of this evidence has led scientists to think of depression in a different way: as a disease of the whole person in which the symptoms are most evident in the brain, and where treatments targeting inflammation in the body might resolve the brain problems. However, it is likely that inflammation is not always the cause of depression, and we know that inflammation comes in different types that require different treatments. So, the current problem is how to identify which of the many patients with depression have inflammation as an underlying cause and exactly what type of inflammation they have. If we can develop simple blood tests to analyse inflammation in depressed patients we would be better placed to choose the best drugs to treat individual patients.

Stratified medicine

A group of UK scientists have teamed up with researchers from several pharmaceutical companies to investigate whether mood disorders, such as depression, and neurodegenerative diseases, such as Alzheimer’s disease, could be treated by targeting the immune system. The group is called NIMA (Neuroimmunology of Mood Disorders and Alzheimer’s Disease).

The first stage of NIMA’s work (currently ongoing) is to develop blood tests and brain imaging tests that can precisely identify those people who have depression associated with whole-body and brain inflammation. The final blood test will likely look at multiple markers of inflammation in the blood and give information that not only tells the clinician that the patient has inflammation but also what sort of inflammation it is. It will then be possible to select the best possible anti-inflammatory drug for that patient, improving the chance of a successful treatment.

And here’s where the clever part of NIMA comes in: to make a new drug costs a huge amount and takes years, but the partner pharmaceutical companies already have many anti-inflammatory drugs in their lockers which have been tested and shown to be safe in patients but are not yet available on the market. NIMA scientists will be able to select drugs from this resource, test them to confirm that they have the desired activity and then take them into small, fast clinical trials in highly selected patients with the right sort of disease.

The new approach of identifying the right patients to treat with the right drugs – called “stratified medicine” – is being used in many areas of medicine, but the work of NIMA means that one of its early successes might be in one of the most difficult diseases to treat: depression. While reaching for the ibuprofen will not resolve depression in everyone, there is the real prospect that many with depression associated with inflammation will soon benefit from individually tailored anti-inflammatory treatments.


This article was originally published on The Conversation. Read the original article.




To subscribe to Facts and Arts' weekly newsletter, please click here.

To follow Facts & Arts' Editor, Olli Raade, on Twitter, please click here.

If you have something to say that you want to say on Facts & Arts, please

Write to the Editor, or write a comment in the comments section.

Browse articles by author

More Essays

May 1st 2021
EXTRACT: " The sad reality is that the Mizrahim (Jews of Middle Eastern and North African descent) were discriminated against from the day of Israel’s inception, whose Ashkenazi (European Jewish) leaders viewed them as intellectually inferior, “backward,” and “too Arab,” and treated them as such, largely because the Ashkenazim agenda was to maintain their upper-class status while controlling the levers of power, which remain prevalent to this day." ..... " The greatest heartbreaking outcome is that for yet another generation of Israelis, growing up in these debilitating conditions has a direct effect on their cognitive development. A 2015 study published in Nature Neuroscience found that “family income is significantly correlated with children’s brain size…increases in income were associated with the greatest increases in brain surface area among the poorest children.” "
Apr 25th 2021
EXTRACT: "We all owe Farah Nabulsi an enormous debt of gratitude. In a short 24-minute film, The Present, she has exposed the oppressive indecency of the Israeli occupation while telling the deeply moving story of a Palestinian family. What is especially exciting is that after winning awards at a number of international film festivals​, Ms. Nabulsi has been nominated for an Academy Award for this remarkable work of art. " 
Apr 25th 2021
EXTRACT: "When I crashed to the floor of my home in Bordeaux recently after two months of Covid-19 dizziness, I was annoyed. The next day I collapsed again. Now I was worried. What I didn’t know was that my brain was sloshing around inside my skull, causing a mild concussion. Nor did I know that I was in for a whole new world of weird and wonderful hallucinations."
Apr 13th 2021
EXTRACT: "Overall, our review has found that there isn’t evidence to back up the claims that veganism is good for your heart. But that is partly because there are few studies ....... But veganism may have other health benefits. Vegans have been found to have a healthier weight and lower blood glucose levels than those who consume meat and dairy. They are also less likely to develop cancer, high blood pressure and diabetes. "
Apr 8th 2021
EXTRACT: "Pollock’s universe, the universe of Mural, cannot be said to be a rational universe. Nor is it simply devoid of all sense. It is not a purely imaginary world, although in it everything is in a constant state of flux. Mural invokes one of the oldest questions of philosophy, a question going back to the Pre-Socratic philosophers Parmenides and Heraclitus – namely, whether the nature of Reality constitutes unchanging permanence or constant movement and flux. For Pollock, the only thing that is truly unchanging is change itself. The only certainty is that all is uncertain."
Apr 8th 2021
EXTRACT: "Many present day politicians appear to have psychopathic and narcissistic traits too. It’s easy to spot such leaders, because they are always authoritarian, following hardline policies. They try to subvert democracy, to reduce the freedom of the press and clamp down on dissent. They are obsessed with national prestige, and often persecute minority groups. And they are always corrupt and lacking in moral principles."
Apr 6th 2021
EXTRACT: "This has led some to claim that not just half, but perhaps nearly all advertising money is wasted, at least online. There are similar results outside of commerce. One review of field experiments in political campaigning argued “the best estimate of the effects of campaign contact and advertising on Americans’ candidates choices in general elections is zero”. Zero!"
Mar 30th 2021
EXTRACT: "The Father is an extraordinary film, from Florian Zeller’s 2012 play entitled Le Père and directed by Zeller. I’m here to tell you why it is a ‘must see’." EDITOR'S NOTE: The official trailer is attached to the review.
Mar 28th 2021
EXTRACT: "Picasso was 26 in 1907, when he completed the Demoiselles; de Kooning was 48 in 1952, when he finished Woman I.  The difference in their ages was not an accident, for studies of hundreds of painters have revealed a striking regularity - the conceptual painters who preconceive their paintings, from Raphael to Warhol, consistently make their greatest contributions earlier in their careers than experimental painters, from Rembrandt to Pollock, who paint directly, without preparatory studies."
Mar 26th 2021
EXTRACT: "Mental toughness levels are influenced by many different factors. While genetics are partly responsible, a person’s environment is also relevant. For example, both positive experiences while you’re young and mental toughness training programmes have been found to make people mentally tougher."
Mar 20th 2021

The city of Homs has been ravaged by war, leaving millions of people homeless an

Mar 20th 2021
EXTRACT: "There are two main rival models of ethics: one is based on rights, the other on duties. The rights-based model, which traces its philosophical origins to the work of John Locke in the 17th century, starts from the assumption that individuals have rights ....... According to this approach, duties are related to rights, but only in a subordinate role. My right to health implies a duty on my country to provide some healthcare services, to the best of its abilities. This is arguably the dominant interpretation when philosophers talk about rights, including human rights." ........ "Your right to get sick, or to risk getting sick, could imply a duty on others to look after you during your illness." ..... "The pre-eminence of rights in our moral compass has vindicated unacceptable levels of selfishness. It is imperative to undertake a fundamental duty not to get sick, and to do everything in our means to avoid causing others to get sick. Morally speaking, duties should come first and should not be subordinated to rights." ..... "Putting duties before rights is not a new, revolutionary idea. In fact it is one of the oldest rules in the book of ethics. Primum non nocere, or first do no harm, is the core principle in the Hippocratic Oath historically taken by doctors, widely attributed to the ancient Greek philosopher and physician Hippocrates. It is also a fundamental principle in the moral philosophy of the Roman statesman Marcus Tullius Cicero, who in De Officiis (On Duties) argues that the first task of justice is to prevent men and women from causing harm to others."
Mar 18th 2021
EXTRACT: "Several studies have recently compared the difference between antibodies produced straight after a coronavirus infection and those that can be detected six months later. The findings have been both impressive and reassuring. Although there are fewer coronavirus-specific antibodies detectable in the blood six months after infection, the antibodies that remain have undergone significant changes. …….. the “mature” antibodies were better at recognising the variants."
Mar 15th 2021
EXTRACT: "Like Shakespeare, Goya sees evil as something existing in itself – indeed, the horror of evil arises precisely from its excess. It overflows and refuses to be contained by or integrated into our categories of reason or comprehension. By its very nature, evil refuses to remain within prescribed bounds – to remain fixed, say, within an economy where evil is counterbalanced by good. Evil is always excess of evil." ....... "Nowhere is this more evident than in war. Goya offers us a profound and sustained meditation on the nature of war ........ The image of a Napoleonic soldier gazing indifferently on a man who has been summarily hanged, probably by his own belt, expresses the tragedy of war – its dehumanization of both war’s victims and victors."
Mar 14th 2021
EXTRACT: "A blockchain company has bought a piece of Banksy artwork and burnt it. But instead of destroying the value of the art, they claim to have made it more valuable, because it was sold as a piece of blockchain art. The company behind the stunt, called Injective Protocol, bought the screen print from a New York gallery. They then live-streamed its burning on the Twitter account BurntBanksy. But why would anyone buy a piece of art just to burn it? Understanding the answer requires us to delve into the tricky world of blockchain or “NFT” art."
Mar 14th 2021
EXTRACT: "Exercise is good for your health at every age – and you can reap the benefits no matter how late in life you start. But our latest research has shown another benefit of being physically active throughout life. We found that in the US, people who were more physically active as teenagers and throughout adulthood had lower healthcare costs."
Mar 10th 2021
EXTRACT: "Although around one in 14 people over 65 have Alzheimer’s disease, there’s still no cure, and no way to prevent the disease from progressing. But a recent study may bring us one step closer to preventing Alzheimer’s. The trial, which was conducted on animals, has found a specific molecule can prevent the buildup of a toxic protein known to cause Alzheimer’s in the brain."
Feb 24th 2021
EXTRACT: "The art historian George Kubler observed that scholars in the humanities “pretend to despise measurement because of its ‘scientific’ nature.” As if to illustrate his point Robert Storr, former dean of Yale’s School of Art, declared that artistic success is “completely unquantifiable.” In fact, however, artistic success can be quantified, in several ways. One of these is based on the analysis of texts produced by art scholars, and this measure can give us a systematic understanding of how changes in recent art have produced changes in the canon of art history."
Feb 24th 2021
EXTRACT: "The most politically sensitive option we looked at was the virus escaping from a laboratory. We concluded this was extremely unlikely."
Feb 16th 2021
EXTRACT: ".... these men were completely unaware that they had put their lives in the hands of doctors who not only had no intention of healing them but were committed to observing them until the final autopsy – since it was believed that an autopsy alone could scientifically confirm the study’s findings. As one researcher wrote in a 1933 letter to a colleague, “As I see, we have no further interest in these patients until they die.” ...... The unquestionable ethical failure of Tuskegee is one with which we must grapple, and of which we must never lose sight, lest we allow such moral disasters to repeat themselves. "