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Front. Psychiatry | doi: 10.3389/fpsyt.2019.00605

Neurobiology and Therapeutic Potential of Cyclooxygenase-2 (COX-2) inhibitors for Inflammation in Neuropsychiatric Disorders

  • 1University of Western Ontario, Canada
  • 2Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Malaga, Spain
  • 3School of Medicine, Faculty of Health, Deakin University, Australia
  • 4Barwon Health, Australia
  • 5Florey Institute of Neuroscience and Mental Health, Australia
  • 6Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Australia
  • 7Department of Psychiatry, Melbourne Medical School, University of Melbourne, Australia

Neuropsychiatric disorders, such as depression, bipolar, schizophrenia, obsessive-compulsive disorder, and neuropsychiatric disorders such as autism spectrum disorder, are associated with significant illness burden. Accumulating evidence supports an association between neuropsychiatric illnesses and inflammatory processes. Consequently, potent anti-inflammatory agents, such as the cyclooxygenase-2 inhibitors, represent a novel avenue to prevention and treatment of neuropsychiatric illness. In this paper, we first review the role of inflammation in psychiatric pathophysiology including inflammatory cytokines’ influence on neurotransmitters, the hypothalamic-pituitary-adrenal axis, and microglial mechanisms. Then we discuss how cyclooxygenase-2 inhibitors influence these pathways with potential therapeutic benefit. A search was conducted in PubMed, Embase, PsychINFO, and trial registries, Clinicaltrials.gov and The Stanley Medical Research Institute. The results were presented as a narrative review format. Currently available outcomes for randomized controlled trials up to November 2017 are also reviewed. The evidence reviewed here suggests cyclooxygenase-2 inhibitors may indeed help to treat the symptoms of neuropsychiatric disorders; however, further studies are required to assess appropriate illness stage-related indication.

Keywords: Inflammation, Cyclooxegenase-2, Depression, bipolar, Schizophrenia

Received: 17 Sep 2018; Accepted: 30 Jul 2019.

Edited by:

Richard G. Boles, Center for Neurological and Neurodevelopmental Health (CNNH), United States

Reviewed by:

Marisa Moller, North-West University, South Africa
Akira Monji, Saga University, Japan  

Copyright: © 2019 Sethi, Gómez-Coronado, walker, Robertson, Agustini, Berk and Dodd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Oliver D. Robertson, School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, 3216, Australia, oliver.robertson@barwonhealth.org.au
Prof. Michael Berk, School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, 3216, Australia, MICHAEL.BERK@barwonhealth.org.au