Summary: Minocycline, a broad-spectrum tetracycline antibiotic, has shown promise in the treatment of depression. Researchers say the antibiotic could help reduce brain inflammation associated with some cases of major depressive disorder. A small study conducted by researchers at Deakin University found those treated with Minocycline reported improved quality of life, reduced anxiety symptoms and a better global impression of their depression.
Source: Deakin University.
Researchers from IMPACT have discovered that a drug used to treat acne can relieve major depression.
An antibiotic used mostly to treat acne has been found to improve the quality of life for people with major depression, in a world-first clinical trial conducted at Deakin University.
The trial added a daily dose of minocycline – a broad-spectrum antibiotic that has been prescribed since 1971 – to the usual treatment of 71 people experiencing major depression.
The research team, led by Deakin’s Centre for Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), then compared the effects to a control group taking a placebo.
The results – recently published in the “Australian and New Zealand Journal of Psychiatry” – showed that those taking minocycline reported improved functioning and quality of life.
Lead researcher Dr Olivia Dean said the research took a unique “biological” approach to treating depressive symptoms, which could inform future therapies.
“There is evidence to suggest that people with major depressive disorder have increased levels of inflammation in their body,” Dr Dean said.
“We believe that minocycline is targeting more recently understood biological factors, including inflammation. Specifically, minocycline reduces brain inflammation in cell models, and thus we wanted to see if it was useful for people.”
Dr Dean said there was a huge need for improved treatment options for people with major depression.
“We’ve found that using old medications for new purposes is very useful,” she said. “Existing medications have known safety profiles and are readily accessible so they can be prescribed immediately.”
In Australia, up to one in six people will have experienced depression over the past 12 months.
“Current antidepressants are useful, but many people find a gap between their experience before becoming unwell and their recovery following treatment,” Dr Dean said. “It’s clear that this shortfall in recovery is probably linked to a gap in biological targets by these conventional medications.”
“We aim to fill this gap by providing new, biologically-based, treatments for depression.”
Dr Dean has also been leading a clinical trial using the rind of the tropical fruit mangosteen for treatment of depressive symptoms.
She said the minocycline trial was small, but did have some significant results.
“We found that those on minocycline reported significant improvements in functioning, quality of life, global impression of their illness, and there was also a trend towards improvements in anxiety symptoms.”
Dr Dean and her team are now in the process of applying for funding to expand the trial to a larger group.
“This was a preliminary trial and more research is needed to determine the optimal time minocycline should be taken for. It should be noted that the trial was conducted in addition to participants’ usual treatment for depression. We’re also considering a study of minocycline for people with anxiety disorders, given what we have found in this study,” she said.
Funding: This research was supported by Deakin University, the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Barwon Health, Chulalongkorn University, the Brain and Behavior Foundation (USA), and an Australasian Society for Bipolar and Depressive Disorders/Servier grant.
Source: Deakin University
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Original Research: Abstract for “Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial” by Olivia M Dean, Buranee Kanchanatawan, Melanie Ashton, Mohammadreza Mohebbi, Chee Hong Ng, Michael Maes, Lesley Berk, Atapol Sughondhabirom, Sookjaroen Tangwongchai, Ajeet B Singh, Helen McKenzie, Deidre J Smith, Gin S Malhi, Nathan Dowling, and Michael Berk in Australian and New Zealand Journal of Psychiatry. Published online June 3 2017 doi:10.1177/0004867417709357
[cbtabs][cbtab title=”MLA”]Deakin University “Old Antibiotic Could Form New Depression Treatment.” NeuroscienceNews. NeuroscienceNews, 19 July 2017.
<https://neurosciencenews.com/antibiotic-antidepressant-7121/>.[/cbtab][cbtab title=”APA”]Deakin University (2017, July 19). Old Antibiotic Could Form New Depression Treatment. NeuroscienceNew. Retrieved July 19, 2017 from https://neurosciencenews.com/antibiotic-antidepressant-7121/[/cbtab][cbtab title=”Chicago”]Deakin University “Old Antibiotic Could Form New Depression Treatment.” https://neurosciencenews.com/antibiotic-antidepressant-7121/ (accessed July 19, 2017).[/cbtab][/cbtabs]
Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial
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, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder.
A total of 71 adults with major depressive disorder (Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition) were randomised 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 Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au, #ACTRN12612000283875.
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 Questionnaire 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.
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.
“Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial” by Olivia M Dean, Buranee Kanchanatawan, Melanie Ashton, Mohammadreza Mohebbi, Chee Hong Ng, Michael Maes, Lesley Berk, Atapol Sughondhabirom, Sookjaroen Tangwongchai, Ajeet B Singh, Helen McKenzie, Deidre J Smith, Gin S Malhi, Nathan Dowling, and Michael Berk in Australian and New Zealand Journal of Psychiatry. Published online June 3 2017 doi:10.1177/0004867417709357