Anti-Inflammatory Agents: Can They Target Anhedonia in Depression?

Abstract

Anti-inflammatory agents used adjunctively modestly reduced depressive symptoms and anhedonia in patients with CRP above 2 mg/L. However, they did not improve response or remission rates. CRP remains the best available biomarker for inflammatory depression but is nonspecific; routine screening is not yet warranted. For treatment-resistant depression with elevated CRP and prominent anhedonia, a time-limited adjunctive trial of celecoxib or minocycline may be reasonable after failing first- and second-line agents. Anhedonia includes anticipatory and consummatory facets mediated by distinct circuits. Most scales measure only consummatory anhedonia, potentially missing the full clinical picture.