Role of Minocycline as an Adjunct Neuroinflammatory Modulator in Treatment-Resistant Depression: A Systematic Review of Randomized Controlled Trials.

Objective: To assess the efficacy and safety evidence for adjunct minocycline in treatment-resistant depression (TRD).Data Sources: In this systematic review, PubMed, PubMed Central, Embase, and Google Scholar were searched from inception to October 2022. The following keywords were utilized in the search: "depression" AND "minocycline" AND "treatment, pharmacological intervention, management." Medical Subject Heading terms for "minocycline" and "depression, depressive disorder, treatment-resistant," and "disease management" were also used. Relevant peer-reviewed, English-language articles that included adults and children were selected for final evaluation.Study Selection: Two authors independently searched and selected 1,004 relevant articles. Only randomized controlled trials were considered. Five articles were identified that fulfilled the inclusion criteria.Data Extraction: The PICO algorithm (Population, Intervention, Comparison, Outcomes, and Study Design) framework was utilized, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria guidelines were followed. The Cochrane risk of bias tool was used to categorize the included study as a low, unclear, or high risk of bias.Results: Minocycline as an adjunct immunomodulator shows inconsistent benefit in TRD. Minocycline has some beneficial effect on depression scale scores and inflammatory markers in TRD patients with inflammatory disequilibrium (C-reactive protein elevation exceeds 3 mg/L). However, minocycline showed an inconclusive effect in TRD with no clear immunologic dysregulation. Minocycline might have a neuroprotective, rather than therapeutic, effect at a small dose.Conclusions: The results were inconsistent regarding the clinical and neuroprotective role of minocycline in TRD. More study is needed to clarify the pathophysiologic and clinical role of minocycline as an immunomodulator in TRD.Prim Care Companion CNS Disord 2023;25(5):22r03467. Author affiliations are listed at the end of this article.

Polymorphism of the ADIPOQ gene and its association with productive traits in Awassi Ewes.

BACKGROUND: Adiponectin (ADIPOQ) plays a critical role in energy and lipid metabolism, indicating that adiponectin could affect livestock productivity. There is an association between polymorphisms in the ADIPOQ gene and variations in livestock productive traits. Therefore, this study investigated the relationship between ADIPOQ polymorphism and productive traits in Awassi ewes. METHODS AND RESULTS: This study included 200 sexually mature ewes, aged 2.5 to 5 years, non-pregnant and not lactating. A phenotypic measurement consisting of live weight and body dimensions, was taken. Samples of blood were taken for extraction of genomic DNA and PCR-SSCP based genotyping, followed by sequencing to confirm variants in amplified fragments. A novel c.198,473,337 C > A SNP was found in exon 1 of the ADIPOQ gene confirming heterogeneity with genotypes AA, CC, and CA. The AA genotype differed significantly (P < 0.05) by comparison with the CA and CC genotypes concerning live body weight and body measurements. An association between productive traits and the c.198,473,337 C > A SNP revealed a significant association of the A allele (odds ratio: 2.22 (95% CI: 0.94-5.30) in the additive genetic model. CONCLUSION: Sheep with the AA genotype were heavier and had larger body dimensions, implying superior production and reproduction. Further studies are required in other breeds to prove the results.

Pharmacological Interventions of Atypical Antipsychotics Induced Weight Gain in the Pediatric Population: A Systemic Review of Current Evidence.

To systematically review studies evaluating pharmacological treatment intervention of the atypical antipsychotic induced weight gain in the pediatric population and summarize the current evidence of the pharmacological treatment. According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we searched the various databases Medline, PubMed, PubMed central (PMC), CINAHL, and clinicaltrial.gov. until Jan 30th, 2022 for relevant clinical studies. Medical subject heading (MeSH) terms or keywords were used, "Body Weight," "Weight Gain," "Weight Loss," "Body Weight Maintenance," "Pediatric Obesity" in "Pediatrics," "Adolescent," "Child" in context of "Antipsychotic Agents" and "Drug Therapy," "Therapeutics," "Treatment Outcome," "Early Medical Intervention." We used the PICO algorithm for our search (Population, Intervention, Comparison, Outcomes, and Study Design) framework. The initial search included 746 articles, nine studies were ultimately selected in the final qualitative review. We included relevant clinical reviews, case series, and randomized clinical trials that evaluated pharmacological intervention for antipsychotic-induced weight gain in the pediatric population. Non-peer-reviewed, non-human, non-English languages article was excluded. Metformin is the most studied medication for antipsychotic-induced weight gain in children. Three studies have shown that adding Metformin to the antipsychotics can significantly reduce the body weight and body mass index with mild transient side effects. Other adjunct medications like topiramate, amantadine, betahistine, or melatonin vary greatly in mitigating weight with various side effects. Lifestyle modification is the first step in dealing with AIWG, but the result is inconsistent. Avoiding the use of antipsychotic in children is preferred. Adding an adjuvant medication to the antipsychotic could prevent or mitigate their negative metabolic effect on the body weight and body mass index. Metformin has the most evidence, topiramate, betahistine, amantadine, and melatonin is possible alternatives in the pediatric patient without changing their antipsychotic medication. Other viable options show some benefits but need further clinical studies to establish efficacy and safety.