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Efficacy and safety of celecoxib for treatment of mild to moderate postpartum depression: a randomized, double-blind, placebo-controlled trial

  • Maternal-Fetal Medicine
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Abstract

Purpose

Evidence has demonstrated the roles of inflammatory processes in pathogenesis of depression. We aim to assess the effects of adjunctive celecoxib with cognitive behavioral therapy (CBT), an anti-inflammatory agent, in treatment of postpartum depression and on levels of Brain-derived neurotrophic factor (BDNF) and inflammatory cytokines.

Methods

This was a randomized, double-blind, placebo-controlled trial to investigate the effects of adjunctive celecoxib with CBT on postpartum depression. Fifty outpatient women with postpartum depression, participated in this study. Patients randomly received either a celecoxib capsule twice a day or a placebo capsule twice a day for 6 weeks. Patients were assessed using the Hamilton Depression Rating Scale (HDRS) and the adverse event checklist at baseline and weeks 2, 4, and 6.

Results

Patients in the celecoxib group showed a greater decline in HDRS scores from baseline to all three study time points compared to the placebo group (p = 0.12 for week 2, p = 0.001 for week 4, p < 0.001 for week 6). Rate of response to treatment was significantly higher in the celecoxib group compared to the placebo group at week 4 (60 vs 24%, p = 0.010) and week 6 (96 vs 44%, p < 0.001). Rate of remission was significantly higher in the celecoxib group compared to the placebo group at week 4 (52 vs 20%, p = 0.018) and week 6 (96 vs 36%, p < 0.001). Levels of most inflammatory markers were significantly lower in the celecoxib group compared to the placebo group at week 6. Levels of BDNF were significantly higher in the celecoxib group compared to the placebo group at week 6 (p < 0.001).

Conclusions

Findings suggest adjunctive celecoxib is an effective treatment for the improvement of postpartum depressive symptoms.

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Data availability

The data that support the findings of this study are available upon request from the corresponding author.

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Acknowledgements

This study was the postgraduate thesis of Dr. Sophia Esalatmanesh toward the Iranian Board of Genecology and Obstetrics and Ph.D of Neuroscience (MD., Ph.D. program).

Funding

This study supported by a grant from Tehran University of Medical Sciences (43340).

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Author notes

  1. Sophia Esalatmanesh and Ladan Kahani contributed equally to this study.

Authors and Affiliations

  1. Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Sophia Esalatmanesh, Ladan Kashani & Maryam Khooshideh

  2. Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran, 13337, Iran

    Sophia Esalatmanesh, Hossein Sanjari Moghaddam & Shahin Akhondzadeh

  3. Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Sahar Ansari

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Contributions

SE, SA, HSM and MK participated in data acquisition, analysis and preparation of the first draft of manuscript. SA and LK designed the manuscript, provided the outlines for presentation of the study, supervised the study process and edited the final manuscript. All authors have reviewed the process of data analysis, commented on previous versions of the manuscript, and approved the final article.

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Correspondence to Shahin Akhondzadeh.

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Esalatmanesh, S., Kashani, L., Khooshideh, M. et al. Efficacy and safety of celecoxib for treatment of mild to moderate postpartum depression: a randomized, double-blind, placebo-controlled trial. Arch Gynecol Obstet 309, 1429–1439 (2024). https://doi.org/10.1007/s00404-023-07042-4

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