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For many patients diagnosed with depression, treatment is centered on the use of anti-depressants. Anti-depressants are an effective remedy for many, but some patients struggle with side effects or have a case of depression that does not respond to common anti-depressant medications.

A new study by researchers at Emory University shows that patients who do not respond well to anti-depressants may find renewed hope in the use of medications that treat inflammation. The findings appear in the online publication of Archives of General Psychiatry.

Led by Andrew H. Miller, MD, professor of Psychiatry and Behavioral Sciences at the Emory University School of Medicine, the study shows that medication designed to treat inflammation may offer relief for those with difficult-to-treat cases of depression.

Dr. Miller explains that inflammation is a protective response of the body when it is injured, but it can be damaging to some parts of the body, including the brain, when it occurs in a chronic pattern.

Previous research has demonstrated that those who have depression and also exhibit a high level of inflammation do not typically respond as easily to traditional depression treatments. As a result, Dr. Miller and colleagues sought to find out if an anti-inflammatory medication would be an effective treatment for those with difficult-to-treat depression, or if the treatment might only be effective in depression patients with a high level of inflammation.

The study tested the effectiveness of infliximab, a medication recently introduced to treat rheumatoid arthritis and inflammatory bowel disease. Infliximab is a biologic drug, which is a medication that mimics the effects of the body’s immune system. Infliximab is designed to block tumor necrosis factor (TNF), an important molecule active in inflammation.

The participants in the study were all diagnosed with major depression and had been resistant to traditional treatments. The participants were assigned to take infliximab or to take a placebo.

While the participants did not show a significant difference in treatment results based on improvement of depressive symptoms, those who had been identified as having tested for high levels of inflammation responded significantly better to the medication than to the placebo.

The researchers tested the levels of inflammation by use of a blood test commonly used in clinics and hospitals. The availability of the test to immediately measure the inflammation levels may allow for faster, more successful treatment of some depression patients who also have a high level of depression.

First author Charles L. Raison explains that this study has produced the first findings that support the use of a biologic therapy to treat depression. The study may act as a springboard for other medications that target the immune system and may be useful in treating mental health issues.


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