Effects of celecoxib augmentation of antidepressant or anxiolytic treatment on affective symptoms and inflammatory markers in patients with anxiety disorders: exploratory study
Abstract
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. 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 (CGI-S). Venous blood samples were collected for assays of inflammatory cytokines. 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. 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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- Authors
- Elnazer, H. Y., Sampson, A. P., & Baldwin, D. S.
- Affiliations
- Brighton and Sussex Medical School (GB)
- University of Southampton (GB)
- University of Cape Town (ZA)
- Corresponding author
- Elnazer, Hesham Y.
- Venue
- International Clinical Psychopharmacology
- Published
- 2021-03-12
- Volume
- 36
- Issue
- 3
- Pages
- 126-132
- ISSN
- 0268-1315 (ISSN-L)
- OpenAlex
- W3137263429
- Cited by
- 21
- References
- 43
- Citations by year
- 2025: 6 · 2024: 2 · 2023: 4 · 2022: 9
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- celecoxib, anxiety disorders, antidepressant augmentation, anxiolytic treatment, COX-2 inhibitors, inflammatory cytokines, depressive symptoms, anxiety symptoms, psychological well-being, emotional responsiveness, anti-inflammatory activity
- MeSH terms
- Celecoxib, Affective Symptoms, Antidepressive Agents, Anxiety Disorders, Humans, Pilot Projects, Anti-Anxiety Agents, Biomarkers, Cytokines, Treatment Outcome
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