Low-Dose Aspirin and Minocycline as Adjunctive Treatments for Bipolar Depression

Findings that inflammatory processes can contribute to psychiatric syndromes have inspired studies examining whether anti-inflammatory drugs could help patients (NEJM JW Psychiatry Aug 2017 and Bipolar Disord 2017; 19:198). In the first double-blind, controlled study of anti-inflammatory treatments for bipolar disorder, investigators randomized 99 patients with at least moderate levels of depression despite ongoing conventional treatments (bipolar disorder type I, 37; type II, 57; not otherwise specified, 5) to one of four treatments:

• Low-dose aspirin, which inhibits cyclooxygenase-1 (COX-1; 81 mg twice daily), plus placebo

• Minocycline, an anti-inflammatory antibiotic (100 mg twice daily), plus placebo

• Combination aspirin and minocycline

• Double…