***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Thiazolidinediones have shown antidepressant effect in animal studies , as well as in some uncontrolled studies evaluating human subjects with concurrent major depressive disorder ( MDD ) and metabolic syndrome . Although these drugs are insulin sensitizers , they also have important anti-inflammatory , neuroprotective , and anti-excitotoxic properties . Thus , we hypothesized that they would show antidepressant effect in patients with MDD even if it was not accompanied by metabolic disturbances . In this double-blind placebo-controlled study , 40 patients with MDD ( DSM-IV-TR ) and Hamilton depression rating scale-17 ( Ham-D ) score ⩾22 were r and omized to citalopram plus pioglitazone ( 15 mg every 12 h ) ( n=20 ) or citalopram plus placebo ( n=20 ) for 6 weeks . Patients were evaluated using Ham-D ( weeks 0 , 2 , 4 , 6 ) . Repeated-measure analysis of variance ( ANOVA ) and analysis of covariance were used for comparison of scores between the two groups . Treatment response ( ⩾50 % reduction in Ham-D score ) , remission ( Ham-D score⩽7 ) , and early improvement ( ⩾20 % reduction in Ham-D score within the first 2 weeks ) were compared between the two groups using Fisher 's exact test . Pioglitazone showed superiority over placebo during the course of the trial ( F(1 , 38)=9.483 , p=0.004 ) . Patients in the pioglitazone group had significantly lower scores at all time points than the placebo group ( P<0.01 ) . Frequency of early improvement , response ( week 6 ) , and remission was significantly higher in the pioglitazone group ( 95 % , 95 % , 45 % , respectively ) than in the placebo ( 30 % , 40 % , 15 % respectively ) group ( P<0.001 , < 0.001 , 0.04 , respectively ) . Frequency of side effects was similar between the two groups . Pioglitazone is a safe and effective adjunctive short-term treatment in patients with moderate-to-severe MDD even in the absence of metabolic syndrome and diabetes ( http:// clinical trials.gov/ct2/show/NCT01109030 ) OBJECTIVE To investigate whether the cox-2 inhibitor celecoxib has antidepressant effects in bipolar disorder ( BD ) patients during depressive or mixed phases . METHODS We studied 28 DSM-IV BD patients who were experiencing a depressive or mixed episode and were on a stable dose of a mood stabilizer or atypical antipsychotic medication . Subjects were r and omized to receive 6 weeks of double-blind placebo or celecoxib ( 400 mg/day ) treatment . Current mood stabilizer or antipsychotic medication remained at the same doses during the trial . RESULTS Intention-to-treat analysis showed that the patients receiving celecoxib had lower Hamilton Depression Rating Scale ( HamD ) scores after 1 week of treatment compared to the patients receiving placebo , but this difference was not statistically significant ( p = 0.09 ) . The improvement in the first week of treatment was statistically significant when the analysis included only the subjects who completed the full 6-week trial ( p = 0.03 ) . The two groups did not differ significantly on depressive or manic symptoms from the second week until the end of the trial . Celecoxib was well tolerated with the exception of two subjects who dropped out of the study due to rash . CONCLUSIONS Our findings suggest that adjunctive treatment with celecoxib may produce a rapid-onset antidepressant effect in BD patients experiencing depressive or mixed episodes OBJECTIVE The authors ' goal was to assess dexamethasone for the treatment of depression . METHOD Thirty-seven out patients ( 11 men and 26 women ) meeting DSM-III-R criteria for major depressive disorder were r and omly assigned to receive either placebo or 4 mg/day of oral dexamethasone for 4 days . Baseline Hamilton depression scale scores were compared with scores obtained 14 days after the first dose of study medication . Data were analyzed by using two- sample t tests , chi-square methods , and Fisher 's exact test . RESULTS Seven ( 37 % ) of the 19 patients given dexamethasone but only one ( 6 % ) of the 18 patients given placebo responded positively . No adverse events or side effects were reported , and all patients who entered the study completed it . CONCLUSIONS A brief course of oral dexamethasone ( 4 days ) was significantly more effective than placebo within 14 days for the treatment of depression in a r and omized , double-blind study of depressed out patients BACKGROUND It has been proposed that the mechanism of the antidepressant effect of celecoxib is linked to its anti-inflammatory action and particularly its inhibitory effect on pro-inflammatory cytokines ( e.g. interleukin-6(IL-6 ) ) . We measured changes in serum IL-6 concentrations and depressive symptoms following administration of celecoxib in patients with major depressive disorder ( MDD ) . METHODS In a r and omized double-blind placebo-controlled study , 40 patients with MDD and Hamilton Depression Rating Scale-17 items ( Ham-D ) score ≥18 were r and omly assigned to either celecoxib ( 200 mg twice daily ) or placebo in addition to sertraline ( 200mg/day ) for 6 weeks . Outcome measures were serum IL-6 concentrations at baseline and week 6 , and Ham-D scores at baseline and weeks 1 , 2 , 4 , and 6 . RESULTS The celecoxib group showed significantly greater reduction in serum IL-6 concentrations ( mean difference (95%CI)=0.42(0.30 to 0.55 ) pg/ml , t(35)=6.727 , P<0.001 ) as well as Ham-D scores ( mean difference (95%CI)=3.35(1.08 to 5.61 ) , t(38)=2.99 , P=0.005 ) than the placebo group . The patients in the celecoxib group experienced more response ( 95 % ) and remission ( 35 % ) than the placebo group ( 50 % and 5 % , P=0.003 and 0.04 respectively ) . Baseline serum IL-6 levels were significantly correlated with baseline Ham-D scores ( r=0.378 , P=0.016 ) . Significant correlation was observed between reduction of Ham-D scores and reduction of serum IL-6 levels at week 6 ( r=0.673 , P<0.001 ) . LIMITATIONS We did not measure other inflammatory biomarkers . CONCLUSIONS We showed that the antidepressant activity of celecoxib might be linked to its capability of reducing IL-6 concentrations . Moreover , supporting previous studies we showed that celecoxib is both safe and effective as an adjunctive antidepressant ( Registration number : I RCT 138903124090N1 ) BACKGROUND Several lines of evidence suggest that inflammatory mechanisms may be involved in the severity and progression of depression . One pathway implicated is the production of prostagl and ins via the enzyme cyclooxygenase ( COX ) . Although late-life depression in particular has been associated with inflammation , we know of no published studies using COX inhibitors , such as nonsteroidal anti-inflammatory drugs ( NSAIDs ) , in the treatment of depressive syndromes in this population . OBJECTIVE To evaluate the effect of the NSAIDs celecoxib and naproxen on depressive symptoms in older adults . METHODS The Alzheimer 's Disease Anti-inflammatory Prevention Trial was a r and omized , placebo-controlled , double-masked clinical trial conducted at six U.S. memory clinics . Cognitively normal volunteers age 70 and older with a family history of Alzheimer-like dementia were r and omly assigned to receive celecoxib 200 mg twice daily , naproxen sodium 220 mg twice daily , or placebo . The 30-item version of the Geriatric Depression Scale ( GDS ) was administered to all participants at enrollment and at yearly follow-up visits . Participants with a GDS score greater than 5 at baseline were classified as depressed . RESULTS Of 2,528 participants enrolled , 2,312 returned for at least one follow-up visit . Approximately one-fifth had significant depressive symptoms at baseline . Mean GDS score , and the percentage with significant depressive symptoms , remained similar over time across all three treatment groups . Furthermore , there was no treatment effect on GDS scores over time in the subgroup of participants with significant depressive symptoms at baseline . In longitudinal analysis using generalized estimating equations ( GEE ) regression , higher baseline GDS scores , a prior psychiatric history , older age , time in the study , and lower cognition interacting with time , but not treatment assignment , were associated with significantly higher GDS scores over time . CONCLUSION Treatment with celecoxib or naproxen did not improve depressive symptoms over time compared with placebo . While inflammation has been implicated in late-life depression , these results do not support the hypothesis that inhibition of the COX pathway with these NSAIDs at these doses alleviates depressive symptoms in older adults Background : The pathophysiology of depression is associated with the hyperactivity of immune inflammatory responses . Cyclooxygenase‐2 inhibitors such as celecoxib reduce the production of pro‐inflammatory cytokines . The purpose of the present investigation was to assess the efficacy of celecoxib as an adjuvant agent in the treatment of major depression in a six‐week double blind and placebo controlled trial . Methods : Forty adult out patients who met the DSM‐IV‐TR criteria for major depression participated in the trial . Patients have a baseline Hamilton Rating Scale for Depression score of at least 18 . Patients were allocated in a r and om fashion : 20 to fluoxetine 40 mg/day plus celecoxib 400 mg/day ( 200 mg bid ) ( morning and evening ) and 20 to fluoxetine 40 mg/day plus placebo . Patients were assessed by a psychiatrist at baseline and after 1 , 2 , 4 , and 6 weeks after the medication started . Results : Although both protocol s significantly decreased the score of Hamilton Rating Scale for Depression over the trial period , the combination of fluoxetine and celecoxib showed a significant superiority over fluoxetine alone in the treatment of symptoms of major depression . There were no significant differences in the two groups in terms of observed side effects . Conclusion : The results of this study suggest that celecoxib may be an effective adjuvant agent in the management of patients with major depression and anti‐inflammatory therapies should be further investigated . Depression and Anxiety , 2009 . © 2009 Wiley‐Liss , Thiazolidinediones have shown beneficial effects in short-term treatment of depression . However , it is unclear whether the antidepressant efficacy of these agents is related to their insulin-sensitizing action . We conducted the present study to compare the antidepressant efficacy of pioglitazone with another insulin-sensitizer , metformin , in obese patients with concomitant polycystic ovarian syndrome ( PCOS ) and major depressive disorder ( MDD ) . In a six-week double-blind study , 50 patients with PCOS and MDD ( DSM-IV-TR criteria ) with Hamilton depression rating scale ( HDRS ) score of < 20 , r and omly received pioglitazone ( 15 mg twice daily ; PO ) or metformin ( 750 mg twice daily ; PO ) . Assessment was done using HDRS ( weeks 0 , 3 , 6 ) together with fasting Insulin , glucose , and lipid profile , liver enzymes , homeostatic model assessment of insulin resistance ( HOMA-IR ) , anthropometric measures , and serum and rogens ( weeks 0 and 6 ) . Pioglitazone was superior to metformin in reducing HDRS scores at the end of the study [ 38.3 % versus 8.3 % reduction from baseline scores , F(1 , 37 ) = 73.513 , P<0.001 ] . Changes from baseline in HOMA-IR values at week 6 were not significantly different between the two groups ( P = 0.888 ) . Baseline ( but not follow-up ) HDRS and HOMA-IR values were significantly correlated ( r = 0.393 , P = 0.012 ) . In multiple regression analysis , treatment with pioglitazone independent of HOMA-IR values predicted greater score reduction on HDRS at week 6 ( st and ardized beta = 0.801 , P<0.001 ) . Biochemical and hormonal profile did not differ between the two groups at week 6 . Metformin was associated with higher frequency of gastrointestinal side effects ( P = 0.014 ) . In summary , we showed that pioglitazone improved depression with mechanisms largely unrelated to its insulin-sensitizing action ( registration number : I RCT 201106081556N23 ) BACKGROUND Anxiety , depression , and impaired health-related quality of life ( HRQoL ) are common in patients with psoriasis . OBJECTIVE We sought to analyze the effect of ustekinumab on these conditions in patients with moderate-to-severe psoriasis . METHODS Patients with moderate-to- 
    Output:
    
AND RELEVANCE Our analysis suggests that anti-inflammatory treatment , in particular celecoxib , decreases depressive symptoms without increased risks of adverse effects .
This study supports a proof-of-concept concerning the use of anti-inflammatory treatment in depression .