***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: Summary Background In the 24-month MS-STAT phase 2 trial , we showed that high-dose simvastatin significantly reduced the annualised rate of whole brain atrophy in patients with secondary progressive multiple sclerosis ( SPMS ) . We now describe the results of the MS-STAT cognitive sub study , in which we investigated the treatment effect on cognitive , neuropsychiatric , and health-related quality -of-life ( HRQoL ) outcome measures . Methods We did a secondary analysis of MS-STAT , a 24-month , double-blind , controlled trial of patients with SPMS done at three neuroscience centres in the UK between Jan 28 , 2008 , and Nov 4 , 2011 . Patients were r and omly assigned ( 1:1 ) to either 80 mg simvastatin  ( n=70 ) or placebo ( n=70 ) . The cognitive assessment s done were the National Adult Reading Test , Wechsler Abbreviated Scale of Intelligence , Grade d Naming Test , Birt Memory and Information Processing Battery ( BMI PB ) , Visual Object and Space Perception battery ( cube analysis ) , Frontal Assessment Battery ( FAB ) , and Paced Auditory Serial Addition Test . Neuropsychiatric status was assessed using the Hamilton Depression Rating Scale and the Neuropsychiatric Inventory Question naire . HRQoL was assessed using the self-reported 36-Item Short Form Survey ( SF-36 ) version 2 . Assessment s were done at study entry , 12 months , and 24 months . Patients , treating physicians , and outcome assessors were masked to treatment allocation . Analyses were by intention to treat . MS-STAT is registered with Clinical Trials.gov , number NCT00647348 . Findings Baseline assessment revealed impairments in 60 ( 45 % ) of 133 patients on the test of frontal lobe function ( FAB ) , and in between 13 ( 10 % ) and 43 ( 33 % ) of 130 patients in tests of non-verbal and verbal memory ( BMI PB ) . Over the entire trial , we noted significant worsening on tests of verbal memory ( T score decline of 5·7 points , 95 % CI 3·6–7·8 ; p<0·0001 ) and non-verbal memory ( decline of 6·8 points , 4·8–8·7 ; p<0·0001 ) . At 24 months , the FAB score was 1·2 points higher in the simvastatin-treated group than in the placebo group ( 95 % CI 0·2–2·3 ) . The simvastatin group also had a 2·5 points better mean physical component score of the SF-36 ( 95 % CI 0·3–4·8 ; p=0·028 ) . A treatment effect was not noted for any other outcomes . Interpretation To our knowledge , this SPMS cohort is the largest studied to date with comprehensive longitudinal cognitive , neuropsychiatric , and HRQoL assessment s. We found evidence of a positive effect of simvastatin  on frontal lobe function and a physical quality -of-life measure . Although we found no effect of simvastatin on the other outcome measures , these potential effects warrant confirmation and underline the importance of fully assessing cognition and quality of life in progressive multiple sclerosis treatment trials . Funding The Moulton Foundation , the Berkeley Foundation , the Multiple Sclerosis Trials Collaboration , the Rosetrees Trust , a personal contribution from A W Pidgley CBE , and the National Institute for Health Research University College London Hospitals Biomedical Research Centre and University College London 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 ) Background : Evidence suggests that anti-inflammatory medication may be effective in the treatment of depressive symptoms . In this study , we aim ed to investigate whether minocycline added to treatment as usual ( TAU ) for 3 months in patients with treatment-resistant depression will lead to an improvement in depressive symptoms . Methods : Multi-site , 12-week , double-blind , placebo-controlled , pilot trial of minocycline added to TAU for patients suffering from DSM-5 major depressive disorder , whose current episode has failed to respond to at least two antidepressants . The primary outcome measure was mean change in Hamilton Depression Rating Scale ( HAMD-17 ) scores from baseline to week 12 . Secondary measures were the Clinical Global Impression scale ( CGI ) , Patient Health Question naire-9 ( PHQ-9 ) , the Generalised Anxiety Disorder scale ( GAD-7 ) and EuroQoL ( EQ-5D ) quality -of-life question naire . Side-effect checklists were also used . Minocycline was started at 100 mg once daily ( OD ) and increased to 200 mg after 2 weeks . Results : A total of 41 participants were r and omised , with 21 in the minocycline group and 20 in the placebo group . A large decrease in HAMD scores was observed in the minocycline group compared to the placebo group ( st and ardised effect size ( ES ) –1.21 , p < 0.001 ) . CGI scores in the minocycline group also showed a large improvement compared with placebo ( odds ratio ( OR ) : 17.6 , p < 0.001 ) . PHQ-9 , GAD-7 and EQ-5D total showed more moderate improvements ( ES ~ 0.4–0.5 ) . Conclusion : The findings indicate that adjunctive minocycline leads to improvement in symptoms of treatment-resistant depression . However , our findings require replication in a larger sample . Trial Registration : Clinical Trials.gov identifier : NCT02263872 , registered October 2014 Cancer-related inflammation is an essential process in malignancies . Celecoxib , a nonsteroidal anti-inflammatory drug that acts via the selective inhibition of cyclooxygenase (COX)-2 , has shown favorable effects in several psychiatric disorders . The present study aim ed to assess the safety and efficacy of celecoxib single therapy on depressive symptoms of patients with colorectal cancer who underwent chemotherapy . The study was conducted as a 6-week , parallel-group , r and omized , double-blind , placebo-controlled trial . Forty participants r and omly received either 400mg/day celecoxib or placebo . Treatment effect was assessed using the Hamilton Depression Rating Scale ( HDRS ) and Visual Analogue Scale ( VAS ) score at baseline and at week 2 , 4 and 6 of the trial . Over 6 weeks , patients who received celecoxib showed significant improvement in scores of the Hamilton Depression rating Scale ( P=0.003 ) . When comparing the Mean Difference ( 95 % CI ) between the two groups of therapy , the celecoxib group demonstrated greater reduction in HDRS score during the study period at weeks 4 ( 1.95 , 95 % CI 0.27 - 3.63 , P value = 0.024 ) and 6 ( 2.60 , 95 % CI 0.96 - 4.23 , P=0.003 ) . This study indicates celecoxib as a potential monotherapy treatment strategy for mild to moderate depression in patients with colorectal cancer who underwent chemotherapy Objective : Conventional antidepressant treatments result in symptom remission in 30 % of those treated for major depressive disorder , raising the need for effective adjunctive therapies . Inflammation has an established role in the pathophysiology of major depressive disorder , and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth . This double-blind , r and omised , placebo-controlled trial examined adjunctive minocycline ( 200 mg/day , in addition to treatment as usual ) for major depressive disorder . This double-blind , r and omised , placebo-controlled trial investigated 200 mg/day adjunctive minocycline ( in addition to treatment as usual ) for major depressive disorder . Methods : A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition ) were r and omised to this 12-week trial . Outcome measures included the Montgomery – Asberg Depression Rating Scale ( primary outcome ) , Clinical Global Impression – Improvement and Clinical Global Impression – Severity , Hamilton Anxiety Rating Scale , Quality of Life Enjoyment and Satisfaction Question naire , Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool . The study was registered on the Australian and New Zeal and Clinical Trials Register : www.anzctr.org.au , # ACTRN12612000283875 . Results : Based on mixed- methods repeated measures analysis of variance at week 12 , there was no significant difference in Montgomery – Asberg Depression Rating Scale scores between groups . However , there were significant differences , favouring the minocycline group at week 12 for Clinical Global Impression – Improvement score – effect size ( 95 % confidence interval ) = −0.62 [ −1.8 , −0.3 ] , p = 0.02 ; Quality of Life Enjoyment and Satisfaction Question naire score – effect size ( confidence interval ) = −0.12 [ 0.0 , 0.2 ] , p < 0.001 ; and Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool score – 0.79 [ −4.5 , −1.4 ] , p < 0.001 . These effects remained at follow-up ( week 16 ) , and Patient Global Impression also became significant , effect size ( confidence interval ) = 0.57 [ −1.7 , −0.4 ] , p = 0.017 . Conclusion : While the primary outcome was not significant , the improvements in other comprehensive clinical measures suggest that minocycline may be a useful adjunct to improve global experience , functioning and quality of life in people with major depressive disorder . Further studies are warranted to confirm the potential of this accessible agent to optimise treatment outcomes Previous studies suggest that insulin-sensitizing agents could play a significant role in the treatment of major depression , particularly depression in patients with documented insulin resistance or those who are resistant to st and ard psychopharmacological approaches . This study aim ed to assess the effects on depressive symptoms with adjuvant treatment with the PPARγ-agonist pioglitazone .  Patients ( N=37 ) with non-psychotic , non-remitting depression receiving st and ard psychiatric regimens for depression were r and omized across an insulin sensitivity spectrum in a 12-week double blind , r and omized controlled trial of pioglitazone or placebo . Improvement in depression was associated with improvement in glucose metabolism but only in patients with insulin resistance . An age effect was also shown in that response to pioglitazone was more beneficial in younger aged patients . Study findings suggest differential improvement in depression severity according to both glucose metabolic status and level of depression at baseline . A greater underst and ing of the reciprocal links between depression and IR may lead to a dramatic shift in the way in which depression is conceptualized and treated , with a greater focus on treating and /or preventing metabolic dysfunction BACKGROUND The administration of statins seems to be a promising new avenue in the treatment of patients suffering from major depressive disorder ( 
    Output:
    
Anti-inflammatory agents  improved antidepressant treatment effects .