Rai Khalid Farooqi, Maryum Khalid, Ali Zulqernain.
Adjuvant Therapy in Depression: A review.
J Pak Psych Soc Jan ;12(2):32-6.

Major depression is a disabling disorder. With ever increasing disease burden and projected rise in disability, it is the focus of a lot of research. Although the current first line antidepressant therapy is much better in terms of safety profile than its predecessors, in terms of remission it has only a slight advantage. Main emphasis of research on depression, thus, rests on finding of treatment regimens capable of bringing sustained remission to the fateful patients with a desirable safety profile. In this pursuit, many aspects of depressive illness have been unearthed which are suggestive a lot of innovation in the treatment strategy. These groups include cortisol synthesis inhibitors, microglial activation inhibitors, mechanistic target of rapamycin (mTOR) pathway inhibitors, inhibitors of tryptophan-kyneurinine pathway, corticotropin releasing factor 1 (CRF1) receptor inhibitors, P2X7 receptor inhibitors and anti-inflammatory agents. Many of these agents are under the process of experimentation for approval to be used in humans. Anti-inflammatory agents, however, are many in number and already approved for human use. Therefore, their use can be readily investigated and justifiably recommended as adjuvant in antidepressant pharmacotherapy. Here, we review clinical and pre-clinical evidence regarding some members of anti-inflammatory agents for their potential use as an additional drug in treatment of depression refractory to the first line antidepressant therapy.

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