In addition to considering the possible applications/ repurposing of anti-inflammatory agents for mood disorders, preliminary results suggest that inflammatory biomarkers/ biosignatures may offer some predictive information as to response to conventional antidepressants. For example, a recently published study utilizing a post-hoc methodology concluded that baseline HRCSP levels may identify individuals preferentially response to SSRIs or serotonin and norepinephrine inhibitors.17

It should not be forgotten that non-pharmacological approaches, such as mindfulness-based therapy, aerobic exercise, dietary modification, sleep/ chronobiological normalization as well as a healthier lifestyle may also exert beneficial influences on immunoinflammatory functioning, providing further impetus for integrative approaches to disease modelling and treatment.18

In conclusion, disturbances in the neuroinflammatory system are implicated and empirically supported by both clinical and preclinical evidence to be relevant to the pathogenesis and possibly treatment of mood and other brain disorders. Research vistas for the future are to refine markers across brain illnesses with consideration given to symptomatic status and phase in illness trajectory.

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Although beyond the available data, it is reasonable for clinicians to encourage patients to reduce the risk for “inflammatory-based” medical morbidity, e.g. overweight/obesity and to engage in broad-based therapeutic endeavours in lifestyle changes that would exert a favourable influence on their inflammatory system.

Roger McIntyre, MD, is head of the Mood Disorders Psychopharmacology Unit at the University Health Network, in Toronto, Canada. He is also a member of the Psychiatry Advisor editorial board.


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