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Effects of celecoxib augmentation of antidepressant or anxiolytic treatment on affective symptoms and inflammatory markers in patients with anxiety disorders: exploratory study

Effects of celecoxib augmentation of antidepressant or anxiolytic treatment on affective symptoms and inflammatory markers in patients with anxiety disorders: exploratory study
Effects of celecoxib augmentation of antidepressant or anxiolytic treatment on affective symptoms and inflammatory markers in patients with anxiety disorders: exploratory study
Background: Prolonged stress has been associated with elevated levels of circulating proinflammatory cytokines. Cyclo-oxygenase-2 inhibitors such as celecoxib exert anti-inflammatory effects and may enhance the response to antidepressant drug treatment in patients with depressive disorders, but their effect on anxiety symptoms in patients with anxiety disorders is uncertain. Methods: Patients with a primary diagnosis of an anxiety disorder, with stabilised symptoms, underwent either 6 weeks of celecoxib augmentation of continued treatment (n = 18) or continued ‘treatment as usual’ (n = 9). Assessments included the Warwick–Edinburgh mental well-being scale (WEMWEBS), hospital anxiety and depression scale (HADS), Oxford questionnaire of emotional side effects of antidepressants (OQUESA) and clinical global impression of illness severity (CGIS). Venous blood samples were collected for assays of inflammatory cytokines.
Results: Patients who underwent celecoxib augmentation showed significant reductions in anxiety (HADS-A −3.17) and depressive (HADS-D −2.11) symptoms and in overall illness severity (CGI-S −1.11), and improvements in mental well-being (WEMWBS 7.5) and positive changes in emotional responsiveness (OQUESA-RP −3.56; OQUESA-AC −4.22): these were not seen with ‘treatment as usual’. There were no significant changes in blood levels of inflammatory cytokines in either group.
Conclusion: Celecoxib augmentation appeared associated with beneficial effects on anxiety and depressive symptoms and mental well-being. The findings from this pilot study merit further exploration within a double-blind, randomised placebo-controlled study.
COX-2 inhibitor, anxiety disorders (ADs), celecoxib, inflammation, nonsteroidal anti-inflammatory drugs
0268-1315
126-132
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Elnazer, Hesham Yousry Elhelaly
7e2eb3eb-0f00-455c-95b5-3c2e50f04b33
Sampson, Anthony
4ca76f6f-ff35-425d-a7e7-c2bd2ea2df60
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Elnazer, Hesham Yousry Elhelaly
7e2eb3eb-0f00-455c-95b5-3c2e50f04b33
Sampson, Anthony
4ca76f6f-ff35-425d-a7e7-c2bd2ea2df60

Baldwin, David, Elnazer, Hesham Yousry Elhelaly and Sampson, Anthony (2021) Effects of celecoxib augmentation of antidepressant or anxiolytic treatment on affective symptoms and inflammatory markers in patients with anxiety disorders: exploratory study. International Clinical Psychopharmacology, 36 (3), 126-132, [ICP3066]. (doi:10.1097/YIC.0000000000000356).

Record type: Article

Abstract

Background: Prolonged stress has been associated with elevated levels of circulating proinflammatory cytokines. Cyclo-oxygenase-2 inhibitors such as celecoxib exert anti-inflammatory effects and may enhance the response to antidepressant drug treatment in patients with depressive disorders, but their effect on anxiety symptoms in patients with anxiety disorders is uncertain. Methods: Patients with a primary diagnosis of an anxiety disorder, with stabilised symptoms, underwent either 6 weeks of celecoxib augmentation of continued treatment (n = 18) or continued ‘treatment as usual’ (n = 9). Assessments included the Warwick–Edinburgh mental well-being scale (WEMWEBS), hospital anxiety and depression scale (HADS), Oxford questionnaire of emotional side effects of antidepressants (OQUESA) and clinical global impression of illness severity (CGIS). Venous blood samples were collected for assays of inflammatory cytokines.
Results: Patients who underwent celecoxib augmentation showed significant reductions in anxiety (HADS-A −3.17) and depressive (HADS-D −2.11) symptoms and in overall illness severity (CGI-S −1.11), and improvements in mental well-being (WEMWBS 7.5) and positive changes in emotional responsiveness (OQUESA-RP −3.56; OQUESA-AC −4.22): these were not seen with ‘treatment as usual’. There were no significant changes in blood levels of inflammatory cytokines in either group.
Conclusion: Celecoxib augmentation appeared associated with beneficial effects on anxiety and depressive symptoms and mental well-being. The findings from this pilot study merit further exploration within a double-blind, randomised placebo-controlled study.

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ICP3066- anotated 25022021 - Accepted Manuscript
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Accepted/In Press date: 24 February 2021
e-pub ahead of print date: 12 March 2021
Keywords: COX-2 inhibitor, anxiety disorders (ADs), celecoxib, inflammation, nonsteroidal anti-inflammatory drugs

Identifiers

Local EPrints ID: 447724
URI: http://eprints.soton.ac.uk/id/eprint/447724
ISSN: 0268-1315
PURE UUID: 62925df0-0739-47da-9f56-a9ac59906a25
ORCID for David Baldwin: ORCID iD orcid.org/0000-0003-3343-0907

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Date deposited: 18 Mar 2021 17:59
Last modified: 26 Nov 2021 02:37

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Author: David Baldwin ORCID iD
Author: Hesham Yousry Elhelaly Elnazer
Author: Anthony Sampson

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